There has been a dramatic increase in HIV survival since the advent of combination antiretroviral treatments(CART) for children and adolescents. However, children and adolescents continue to present with the range of neurocognitive problems associated with HIV. Common psychiatric presentations are Attention Deficit Hyperactivity Disorder (ADHD), Depression and Anxiety Disorders. Adolescents particularly present with risk behaviours such as substance use and unsafe sexual pracices. Dr Nassen has extensive experience working with HIV positive children resident in Cape Town, South Africa. This work consists of two sections. The first is a case series of HIV positive children who presented to a neuropsychiatric clinic at a children's hospital. The cases describe the neuropsychiatric presentations as well as the life challenges experienced by this group of institutionalized children. The second section details the results of a comprehensive literature review of studies which explored the neurocognitive and psychiatric impact of HIV in children on CART. The concluding chapter reflects the particular clinical service and educational challenges experienced by this patient population.