This document is a review of the scientific evidence and practice experience in providing what has come to be called psychosocial programming and support for children infected with and affected by HIV, and their caregivers. A great deal of attention is currently focused on psychosocial support programmes for children living in communities affected by HIV/AIDS. Efforts to promote the psychosocial well-being of vulnerable children require conditions and assistance that go beyond psychosocial support programmes. The health sector plays a critical role, in providing direct comprehensive services to affected children and families. This review covers the reasons for the shift in focus from psychosocial support programmes to the psychosocial well-being of children, and from psychosocial support programmes to the need to strengthen services, especially health services. Although the greatest wealth of research and experience comes from sub-Saharan, the arguments made, evidence adduced and conclusions reached regarding the support of children are applicable to all contexts.