This study examines the psychosocial needs of children with AIDS and HIV infection based on a cohort of 18 infected children. Fifteen of the children live with their mothers, nine of whom are single mothers. For 14 children the mother is HIV +ve and for a further 8 the father is also HIV +ve. Many children have siblings (10), but only one of these is infected. Close family and grandparents are rarely involved in care and only one child, the oldest, is aware of parental and personal HIV status. Where children attend school or preschool centres none have been informed of the child's HIV infection. Cultural issues are prevalent, especially marked when English is not the first language (n = 10) which renders obstacles for counselling and developmental appraisal. Children in this group are hospitalized more frequently than the parents. Child and parental hospitalization is problematic. Three case situations arising in this group are described in some detail to highlight the nature of the emotional challenges facing carers and service providers.