This study explores secondary school children’s constructions of care and support provided for ‘vulnerable’ schoolchildren in the age of HIV and AIDS. The study attempts to respond to the following two research questions: What are secondary school children’s constructions of care and support in a rural school context in the age of HIV and AIDS? How can the use of participatory arts-based research enable agency in the lives of ‘vulnerable’ secondary school children in a rural school context in the age of HIV and AIDS? The provision of care and support for ‘vulnerable’ school children is of key concern in South African schools since the number of ‘vulnerable’ children is rising because of the increase in the prevalence of HIV and AIDS, which renders many school children ‘vulnerable’. Schools are mandated by departmental policy to provide care and support to ‘vulnerable’ school children, but they are challenged in their implementation of this policy, which leaves ‘vulnerable’ school children inadequately cared for and supported. The input from school children is often not drawn upon, and this hampers the effectiveness of the provision of care and support. This qualitative study is positioned within a critical paradigm, and employs a participatory arts-based research methodology in its intention to take an approach based on the notion of research as intervention. Twenty Grade 11 male and female school children aged 16 to 21, from two secondary schools in the rural Vulindlela district in KwaZulu-Natal, were purposively selected, using inclusion criteria. The Life Orientation teachers assisted in identifying participants from the school register of ‘vulnerable’ schoolchildren. This did not mean that they were living with HIV or AIDS, but that they were ‘vulnerable’, and at risk of dropping out of school. The study made use of a multimodal approach of data generation with the school children, in which several visual methods, such as drawing, photovoice, and collage, as well as reflective free writing, were used in a participatory way as modes of inquiry, representation, and dissemination. The ethics of research with ‘vulnerable’ school children made the dictum, “do the most good” through the research important, and hence the use of the strategy of research as intervention. The data analysis involved two levels – that of the school children’s own analysis of their visual artifacts, and my overarching thematic analysis, using Tesch’s (1990) open coding. Informed by the theoretical frameworks of Bronfenbrenner’s (1979) bio-ecological systems theory and Giddens’s (1984) structuration theory, the findings show that care and support in schools is constructed as a reciprocal relationship, and they point to the importance of school children’s own agency in the provision of care and support. The findings show that school children construct themselves as both visible and invisible in relation to care and support in school, in that they receive care and support but are overlooked in terms of being able to offer input on how care and support should be provided. Furthermore, the findings indicate that school children perceive the school to be an environment that enables but also constrains the provision of care and support: the infrastructure, the safety and security, and the instructional spaces in the school do provide the basics for care and support, but the overt and covert discrimination by school children and teachers, the challenge of putting policies into practice, and the overall fragmented provision of care and support in the school are constraining. Another emerging finding from this study is that secondary school children construct themselves as being included in the strengthening of care and support in rural schools. The use of visual arts-based methods enabled the exploration of how ‘vulnerable’ school children construct care and support in a rural school; the findings also indicated how the use of visual arts-based research contributed to making a difference in the lives of ‘vulnerable’ school children: it was a joyful experience; it leveraged multiple literacies; it contributed to cooperation, collaboration, and collective construction of knowledge; and, in encouraging thought about the issue, it raised critical awareness of, and solutions to, providing care and support in the school. The findings also pointed out how the visual artifacts could be disseminated in the school, and how this could influence the well-being of the community. The findings have implications for how schools provide care and support for ‘vulnerable’ school children. The findings could be engaged with by schools and the Department of Basic Education as a tool to accomplish strengthening the provision of care and support in rural schools, so that care and support are socially and culturally embedded, and to inform policy making through an approach that can be described as being from the ground up.