The impact of HIV infection on health care delivery in haemophilia has been enormous and epoch making. Essential modifications and developments in blood product preparation have led to a shortage of FVIII concentrates and an increased cost to the consumer of the final product. The complexity and extent of the clinical complications in HIV positive haemophiliacs has opened up entirely new medical approaches to haemophilia care. The impact of the antibody positive haemophiliac on his immediate and extended family has been deeply emotional. Health care workers initially developed a negative and hostile approach to the haemophiliac group. This attitude has softened but there has been a drop-out of medical and paramedical staff involved in health care delivery in haemophilia. Finally, because of current viral safety and increased purity of factor VIII and IX concentrates, non infected haemophilic families may look to the future with increased optimism.