SummaryObjectivesThis study aimed to examine the association between Family Adaptability, Partnership, Growth, Affection and Resolve (Family APGAR) and HIV treatment outcomes.DesignA cross-sectional study using the Family APGAR questionnaireSettingThe study was conducted in Kumasi, Ghana, at the Komfo Anokye Teaching Hospital and the Kwame Nkrumah University of Science and Technology HospitalParticipantsConsenting HIV-positive patients who had been on treatment for at least 12 months were recruited.Main outcome measuresThe Family APGAR questionnaire was administered, and relevant data were extracted from hospital records and analysed using STATA®software. The relationship between Family APGAR and treatment outcomes was determined using Chi-squared tests or Fisher's exact test.ResultsApproximately 70.1% of 304 participants were females with a mean age of 41.8 years (±9.9). At treatment initiation, 47.4% of the patients presented at World Health Organisation (WHO) clinical stages I and II and had a CD4 count ≥ 200 cells/mm3. Females were less likely (Odds Ratio= 0.52; 95% CI=0.31 – 0.90, p = 0.018) to report late for treatment compared with the males. After 12 months of treatment, approximately 70% recorded undetectable viral load. Patients with functional families constituted 70.4%, which had a statistically significant relationship with viral load (p = 0.041).ConclusionHIV care providers should incorporate family functionality evaluation into clinical practice and provide early essential support to enhance treatment outcomes.FundingNone declared