issues that might impair the child's development. This includes HIV serologic monitoring until 18 mouths of age to rule out infection;this may also be done with two negative HIV virological test at ages one and four mouths. Recently, HIV-RNA detection on dried blood spots on filter paper was assessed in South Africa, yielding high diagnostic sensitivity and specificity. This approach may allow early diagnosis of HIV infection in areas where molecular biology laboratories are not widespread. Cortrimoxazole prophylaxis (for Pneumocystis pneumonia but also other bacteriological diseases) after the age of six weeks for at least four mouths, regardless of negative viral results, is also recommended. Clinical and labboratory monitoring of the child's growth and development should include screening for other perinatal infections and immunisation, as well as checking for evidence of zidovudine-associated anaemia. developing effective infant care strategies continues to be a significant challenge. So far,most initiatives relating to children have been to reduce perinatal transmission, without providing any other intervention to mothers, their partners or children. As a consequence, infected and non-infected children born to HIV positive parents have often faced being placed in an orphanage hardly an effective, long-term solution. Implementation of a more comprehensive approach to the care of affected families and keeping parents alive and healthy is urgently needed if these children are to have a future.