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Globally, access to HIV services by key populations has always been a challenge even prior the emergence of Coronavirus disease in 2019 (COVID-19). With reference to Zimbabwe, sex workers experienced challenges in accessing HIV services as was exacerbated by the pandemic and related lockdown restrictions. In the given context, it was critical to develop innovative approaches to increase female sex workers’ access to HIV treatment. Such approaches help prevent treatment interruption and contribute to HIV epidemic control. The study aimed to explore and describe the innovative approaches that were adopted to enhance HIV service delivery among female sex workers during the COVID-19 pandemic in Zimbabwe. A qualitative, descriptive phenomenological design was used to attain the study’s objective. Ten purposefully sampled participants were individually interviewed following a semi-structured interview guide. Data were analysed using Colaizzi’s seven steps. The research findings yielded the following themes: participants received differentiated HIV service delivery through community-based outreach, virtual psychosocial interventions, and support systems through peers, family, and institutions. The innovative approaches to promote HIV service delivery during COVID-19 enhanced female sex workers’ access to differentiated person-centred care and promoted treatment continuity. Community workers were also vital in supporting their peers’ treatment adherence. The lessons drawn from this study are critical and can be utilised in different settings.