This book spells out the challenges that mothers as primary care givers face in caring for their HIV positive children. Challenges of ill health, and that of their children. Above all they face the challenge of adjusting to an HIV diagnosis that has not only affected their children but themselves also. The overwhelming impact of stigma prevents them from confronting their problems openly and directly in their own communities. Poor socio- economic factors and lack of support from families and the social service system leave them feeling dis empowered and incapable.These mothers had to contend with giving up their to institutional care as a strategy to survive the financial burden,stigma and rejection that is put on HIV positive members of the society. The way forward is to turn to the old concept of de-institutionalization whereby families are empowered and supported towards community based care of children.