Pediatric HIV (human immunodeficiency virus) infection occurs predominantly in sub-Saharan Africa (SSA). Approximately 2.3 million HIV-infected children under 15 years reside in SSA, representing 88% of the 2.6 million children living with HIV in the world.1 , 2 More than 90% of all HIV‑infected children less than 15 years of age have acquired HIV through mother-to-child transmission during the antenatal period, at the time of delivery, or through breastfeeding. The risk of transmission can be substantially reduced by prevention of mother-to-child transmission (PMTCT) intervention programs that include the administration of antiretroviral therapy (ART) to all HIV-infected women during pregnancy and throughout breastfeeding, and antiretroviral prophylaxis to their newborn infants during the first 6–12 weeks of life3 , 4 In 2015, the World Health Organization recommended that all HIV-infected pregnant and breastfeeding women should commence lifelong ART.5 , 6 Substantial progress has been made in extending the coverage of PMTCT intervention programs. At the end of 2014, 73% of all pregnant and breastfeeding women with HIV infection throughout the world were receiving antiretrovirals to prevent mother-to-child transmission.1 Despite the advances in preventing pediatric HIV infection, many HIV-infected and HIV-exposed but uninfected (HEU) children can be expected to require surgical procedures for the following reasons: