PIP: The World Health Organization expects there to be 10 million children infected with HIV by the year 2000 as a result of mother to child transmission. Most of these children will in developing countries, but there is also a growing problem in Europe and the US. Rates of HIV-1 transmission from infected mothers to their babies in developing countries range 25-39%, but are as low as 12% in some more developed countries. Recent studies have shown a 26% transmission rate from mothers who were infected post-natally and a 16% rate for those infected pre-natally. Infection rates do not seem to be related to the duration of breast feeding. Pediatricians with experience of HIV infection, however, think that the rate of transmission is much higher than statistics would indicate. AIDS is firmly established among heterosexuals. It should therefore be clear that the number of infected infants and children will continue to increase. The author presents concerns with regard to the clinical management problem of diagnosing HIV infection in children, the main indicator diseases for AIDS in children, the Bangui criteria used for the clinical definition of AIDS, psychological and social factors, confidentiality, childhood immunizations for HIV-infected children, the sexual abuse of children, and children orphaned because of AIDS.