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This systematic review aims to explore barriers that children, adolescents, and young people (ages &lt;\u200925) in the United States may face by exploring family interventions and factors influencing ART adherence. This study conducted a literature search using various databases to retrieve studies within the United States. A total of 36 studies identified family factors (<jats:italic>n =\u200929<\/jats:italic>) and various interventions (<jats:italic>n =\u20097<\/jats:italic>). Across both categories, studies indicated the critical role of family involvement in adherence outcomes. The review also identified significant barriers to ART adherence, including complex medication regimens, HIV-related stigma, and psychosocial stressors. Due to the diverse barriers, policymakers and healthcare providers should focus on a holistic approach to support ART adherence in HIV-positive youth.<\/jats:p>","DOI":"10.1007\/s10461-025-04721-y","type":"journal-article","created":{"date-parts":[[2025,4,27]],"date-time":"2025-04-27T21:41:39Z","timestamp":1745790099000},"page":"2621-2644","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Family Influences on Antiretroviral Therapy Adherence in Youth with HIV in the United States: A Systematic Review"],"prefix":"10.1007","volume":"29","author":[{"given":"Violeta J.","family":"Rodriguez","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Miranda","family":"Gessert","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Arianna","family":"Guerra","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2025,4,28]]},"reference":[{"key":"4721_CR1","unstructured":"Centers for Disease Control and Prevention. 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