OBJECTIVE: To measure the hearing ability of children with HIV and track their otologic monitoring. METHODS: We evaluated 35 patients, aged 7-12 years, with HIV and any history of otologic changes during their development. All these children were referred by Grupo de Atenção a AIDS Pediátrica to the speech sector at Hospital Nossa Senhora da Conceição in Porto Alegre. We used acoustic immittance measures and tonal and vocal audiometry. RESULTS: We found that 12 children (34.3%) had experienced a hearing threshold change in one or more frequencies tested, 9 (75%) had mild bilateral conductive hearing loss (HL), and 3 (25%) had moderate bilateral conductive HL. We found that 18.5% of the subjects had unilateral tympanic membrane perforation and 22.7% had bilateral perforation. Acoustic reflexes were absent in children with conductive HL. In children who had hearing thresholds within normal limits, above 15dBNA, we found that 3% had absence of contralateral acoustic reflex at frequencies of 2000 or 4000 Hz. DISCUSSION: According to the literature, isolated peripheral auditory disorders are common in children with HIV, mostly arising from middle ear impairment. We verified that most of the studied children had fluctuating mild HL associated with secretory otitis media. CONCLUSION: We found conductive HL-mild-to-moderate, unilateral or bilateral, and with absence of acoustic reflexes-in a high proportion of children with HIV. The findings may be due to inflammation of the middle ear and/or perforation, which is common in this population.