Most children born HIV positive live longer and have more healthy lives since the advent of Anti-Retroviral Therapy (ART), together with the accessibility of Anti-Retroviral Drugs (ARV) to persons living with HIV. However, some of those children find themselves in need of care due to abandonment, orphanhood and / or neglect. In South Africa such children may enter the formal Child and Youth Care System and be placed in centres such as Epworth Child and Youth Care Centre. Due to the complex nature of the consequences of such disclosure or non-disclosure of HIV positive children’s status to them, social service workers are posed with a dilemma. In the absence of clear guidelines and policy around such disclosure, the children concerned may be unaware of their HIV positive status, despite being on a medication regime. The aim of the study was to explore the perceptions of social service workers regarding disclosure of HIV status to children born HIV positive living at Epworth Child and Youth Care Centre in Lambton, Ekurhuleni, South Africa. The study was located within a qualitative research paradigm, and utilised a purposive stratified sample of 15 social service workers form various occupational groupings recruited from Epworth Child and Youth Care Centre. A semi-structured interview schedule was employed as the research tool, with in-depth one-on-one interviews being adopted as a method of data collection. Thematic content analysis was used to analyse the data collected during the interviews. The main findings of the study were that HIV status disclosure is viewed as a complex but essential process as it reinforces children’s ability to adhere to medication regimes and to dispel anxiety and suspicion within themselves and around their status; that non-disclosure may lead to poor or coerced adherence and strains the relationship between the children and the social service workers. Disclosure of children’s HIV positive status can be viewed as complex as it presents both positive and the negative. Recommendations relate to community educative and awareness programmes, policy and practice changes regarding disclosure and none disclosure of children’s HIV positive status, as well as future research.