The present research study undertook a cross-sectional study among 71 adults living with HIV (PLHIV) in Vadodara, (Gujarat- India), to examine how counselling relates to well-being and ART adherence. Primary data were collected via a brief structured questionnaire capturing sex/gender, education, counselling exposure and perceived effectiveness (regular visits; individual/FGD; “any counselling effective”), clinical complexity index (CCI), a 5-point well-being Likert outcome, and 3-level adherence (Higher/Middle/Lower). Analytically, here used descriptive statistics; cross-tabs with χ² and Cramér’s V; and multivariable ordinal logistic regression (statsmodels/SciPy in Python; visual checks with heatmaps/mosaics/joy plots and forest plots; Excel for tabulation). Chi-square tests showed very strong associations between perceived counselling effectiveness and both outcomes (AnyEff vs well-being: χ²≈89.6, df=10, p<10⁻¹⁴, V≈0.75; AnyEff vs adherence: χ²≈76.7, df=6, p<2×10⁻¹⁴, V≈0.71). Education is also related to outcomes (education vs adherence: χ²≈86.9, df=18, p≈5×10⁻¹¹, V≈0.58). In the well-being model, after adjusting for gender, education and CCI, participants who rated counselling as effective had higher odds of being in a better well-being category (OR≈6.64; 95% CI 1.79–24.65; p=0.0046); graduates reported higher well-being than those with secondary education (OR≈6.07; 1.10–33.68; p=0.039); higher CCI trended toward lower well-being (OR≈0.57; 0.22–1.46). In the adherence model, regular counselling visits showed the strongest positive association with better adherence (OR≈75.73; 6.43–892.24; p<0.001), while FGD effectiveness showed a positive trend but with wide uncertainty. Taken together, the evidence consistently indicates that high-quality, regular counselling—supplemented by education-tailored support—improves both adherence and quality of life for PLHIV in this setting