AIDS orphans face far greater financial, educational and psychosocial challenges to their development than their peers with healthy living parents. A cross-sectional survey was conducted, assessing the level and nature of abuse and neglect experienced by AIDS orphans in Conakry and N’Zérékoré, Guinea. Additionally, the degree of perceived social support in children whose parents were still alive and not perceived to be HIV positive, children orphaned by causes other than AIDS, and children orphaned by AIDS was explored. The results suggest that experiences of abuse and neglect are common in AIDS-orphaned children, and that adequate social support from family members is often lacking. However, social vulnerability was not limited to children orphaned due to AIDS. Scaled-up, non-discriminatory interventions to improve the psychosocial well-being of AIDS orphans and other vulnerable children are therefore urgently needed, and should be complemented with sound monitoring and evaluation of their effectiveness, scalability and affordability.