A longitudinal assessment of young adolescents' psychosocial outcomes affected by maternal HIV/AIDS was undertaken, focusing on both parent–child psychosocial ties and peer relationships. Data were taken from the Parents and Children Coping Together (PACT) study, a 15-year study assessing mothers with HIV/AIDS and their well children every six months. Families (N = 118) who participated in PACT II and PACT III are included in the current analyses, who were assessed every six months for 36 months in PACT II, and every six months for 18 months in PACT III (providing 11 time points of data across eight years). Growth curve modeling was applied to assess the associations of maternal health on adolescent's psychosocial outcomes. In terms of their relationship with their mothers living with HIV (MLH), adolescents' psychosocial functioning was negatively impacted by maternal illness, specifically viral load count and vitality levels, whereas several indicators of increased maternal illness (including viral load, vitality, illness symptoms, and health-related anxiety) predicted less attachment with peers. In addition, MLH increased illness was associated with more adolescent autonomy.