Worldwide, more than 1.3 million children are living with HIV/AIDS, which is becoming the leading infectious cause of cognitive and developmental delays, especially in infants and children with marked immune dysfunction. There is compelling evidence that massage therapy may have the potential to enhance immune status and alter the course of HIV disease. In support of this concept, increased immune cytotoxic capacity and improvement in HIV disease progression markers have been demonstrated following massage therapy in HIV-1 seropositive adolescents and adults, even in the absence of antiretroviral treatments. Although the ability of massage therapy to enhance immune function in HIV-1 infected children has not yet been investigated, increased weight gain, decreased stress behavior, and more optimal cognitive and motor development have been reported following massage treatment in studies with premature newborns. The intent of this proposed developmental research grant is to examine the efficacy of massage therapy, an affordable and potentially beneficial complementary/alternative treatment, to promote health and enhance well being in HIV-1 seropositive children in the Dominican Republic, a developing country ravaged by HIV/AIDS. The number of pediatric HIV/AIDS cases has been rapidly rising in the Dominican Republic, and antiretroviral regimens are not yet readily available to slow disease progression. We propose to randomize 54 HIV-1 infected Dominican children aged 3-7 years, to receive massage therapy or standard care/friendly visits, twice weekly for 12 weeks. Preliminary data will be gathered to assess acceptance, safety, and compliance to massage therapy, and examine whether massage treatment will improve immune function, developmental performance and behavioral function. We hypothesize that massage therapy will be a valid, safe, and sustainable form of care. If proven effective, this may have widespread application with a focus on training of family/care givers to administer the massage treatment. Insights obtained from this project will be used to develop an application for future studies to determine the effectiveness of massage therapy, its impact on the immune system, and potential mechanisms involved in preserving health status over time in HIV-1 seropositive children.