Children with perinatally-acquired HIV are living into adolescence and adulthood. As this is a relatively new phenomenon, there is a paucity of research highlighting the complex issues that arise for these children. This qualitative case-study examines the needs of a select group of older children (9-16 years old) with perinatally-acquired HIV in the province of British Columbia, Canada through focus groups and interviews conducted with ten HIV-infected children, 11 family members and 11 service providers. The needs of this population are diverse, reflecting its heterogeneity. However, participants consistently highlighted issues of stigma, sexual health and mental health as major areas of current and future concern. Continued support, education and future planning in these areas are necessary for older HIV-infected children as they transition out of childhood.