This article reports on a study conducted in 2009 and funded by the Elton John AIDS Foundation, which set out to chart the health and social care needs of children and young people infected with, and affected by, HIV in Scotland. The study had three elements: a scoping study, an epidemiological survey of infected and affected children, and young people and interviews with forty-eight informants (practitioners, parents and carers, and infected and affected children and young people). The study indicates that a number of significant changes have taken place since earlier research on infected and affected children and young people in Scotland. Most critically, it is argued that, at the same time as more people than ever are HIV-positive and a new, younger generation of children is living with HIV, so policy directives in HIV and children's services may make the needs of these children invisible. The paper ends by drawing out conclusions for policy and practice.