Family Support, Mental Well-Being, and ART Adherence among Young Adults with HIV in Western Kenya

Background: Young adults living with HIV face a high burden of mental health disorders that may negatively affect adherence to antiretroviral therapy (ART). Family support has been identified as a key protective factor, yet evidence among young adults in high HIV burden settings in Kenya remains limited. This study assessed the association between family support, mental well-being, and ART adherence among young adults living with HIV in Western Kenya. Methods: A cross-sectional study was conducted among 289 young adults aged 18–30 years receiving HIV care at Chulaimbo Sub-County Hospital, Kisumu County, Kenya. Family support was measured using a family connectedness scale, while mental well-being was assessed using the PHQ-9 and GAD-7 and ART adherence using the Wilson 3-item scale and the MMAS-4. Multivariable regression models examined associations between variables. Results: The mean age of participants was 25.2±3.8 years and 80.3% were female. Depression was reported by 17.3% of participants, anxiety by 11.8%, and comorbid depression and anxiety by 24.2%. Overall, 88.9% demonstrated good or excellent adherence. Higher family support was significantly associated with lower depression and anxiety scores (β = −0.69, 95% CI −1.12 to −0.26, p=0.002) and higher odds of optimal ART adherence (OR = 9.30, 95% CI 1.78–48.67, p=0.008). Conclusions: Strong family support is associated with improved mental well-being and ART adherence among young adults living with HIV. Integrating family-centered and mental health interventions into HIV care programs may enhance treatment outcomes in high-burden settings.