There is a growing understanding of HIV infection in children. Much of this information is gathered in pursuance of a greater understanding of vertical transmission of HIV. Relatively less is known on the impact of HIV in adolescents, even though the majority of people who have AIDS in their twenties were probably infected as teenagers. Mental health is a broad concept and is often used to incorporate cognitive problems, emotional parameters and daily functioning. All these are important aspects for understanding HIV in children. Surprisingly they are often overlooked, with many workers focusing simply on the end of life, grief and death as the only mental health challenge for young children (Mok and Newell, 1995). Although end-of-life aspects are important, and are briefly discussed, living with HIV rather than dying from it is a challenge which cannot be overestimated. This chapter explores HIV infection in infants, children and adolescents, focusing on the family perspective.