The authors address the dynamic role of adolescents affected by HIV and AIDS. They analyse evidence for how intergenerational dynamics interact with HIV-related vulnerability, through the likely influence of being AIDS-affected on vulnerability to HIV infection, and through intergenerational reproductions of structural disadvantages and social determinants of HIV vulnerability. They review evidence of AIDS' impacts on children and of contextual influences on their vulnerability to infection, linked to orphaning, inequality and lack of education. They point to the paucity of longitudinal research into this area and challenges in uncovering structural determinants of vulnerability. Pressure for generalised ‘hard’ evidence in global policy fails to capture context-specific dynamics. Focus shifts from the notion of children as passive ‘objects’ of study to one that includes ‘agency’ as central to adolescents maturing and interacting with multiple challenges. The authors argue for new approaches to research and policy, giving children voice and visibility in these debates.