Previous research has indicated that HIV-infected patients face barriers to adhering to highly active combination antiretroviral therapy (HAART), which must be taken as prescribed. However, most studies that focus on HIV-infected children have relied on reports from the children’s guardians. The current study extends this research by conducting in-depth, face-to-face interviews focusing on barriers to HAART adherence with 9 HIV-infected children and 14 primary guardians, recruited through flyers posted in clinics and community-based organizations throughout Los Angeles, CA. Interview transcripts were analyzed by Ethnograph, a computer software program used for text search and retrieval. Results indicated six key categories of barriers faced by children on HAART: (1) family daily routines; (2) medication side effects; (3) medication taste, size, or shape; (4) the stigma of HIV/AIDS; (5) medications as a reminder of HIV/AIDS; and (6) child deception. Overall, the highly stigmatized nature of HIV/AIDS caused children and families to attempt to keep the medication a secret, which served as a major barrier to medication schedules. The findings also highlight the role of parental guilt in missed medication and the barrier presented by deceiving children of their HIV-infected status. Future studies should focus on cultural and developmental differences that may present barriers to HAART adherence among children. Notes, references