Human Immunodeficiency Virus (HIV) causes a chronic condition that impacts the immune system resulting in infections and lifelong dependence on medication for survival. The growth and health as well as the economic and food security, psychosocial care, education and family composition of children with the virus are also affected 1. The estimated number of children living with HIV globally in 2018 was 2.1 million 2 and at the time, it was estimated that 260 000 of these children (aged 0 to 14) were living in South Africa, with only 58% on treatment 2. According to the Joint United Nations Programme on HIV/AIDS (UNIAIDS) new infections in South African children declined from 25,000 in 2010 to 13,000 in 2017 2. This could largely be due to the increase in the prevention of mother to child transmission (PMTCT) which reduced vertical HIV infections at birth from 3.6% in 2011 to 1.3% in 2017 3. The National Strategic Plan for HIV, TB and STIs 2017-2022, aims to renew the focus on children with HIV and their families to reduce this rate even further 2. Although not yet optimal, the increase in the number of children in South Africa receiving antiretroviral therapy (ART) is due to the revision of the ART guidelines in 2013 and 2015 by the South African National Department of Health 4. These revised guidelines specified that for children between the ages of 5-10 years, ART should commence either when symptomatic or when CD4 < 500 cells/μl