Objective: The impact of HIV/AIDS is felt more in developing countries because of socioeconomic reasons. There is risk of audio vestibular dysfunction with the use of anti-retroviral therapy, which may be ototoxic. This study was to determine the difference between audio-vestibular function in asymptomatic HIV infected and AIDS patients. Method: In this prospective cross sectional study conducted in a tertiary care hospital in South India, the audio-vestibular system of 30 AIDS subjects (group 1) and 30 asymptomatic HIV positive subjects (group 2) and age-matched 30 healthy controls (group 3) were assessed using pure tone audiometry and cold caloric test. Results: Sixteen patients each, in group 1 and group 2, were detected to have hearing loss. In the control group, 4 were detected to have hearing loss. Comparing patient groups 1 and 2 with that of group 3, the p-value was significant ( P = .001). Kobrak’s (modified) test showed 27% of patients in group 1 and 33% of patients in group 2 had a hypofunctioning labyrinth. Conclusion: It was found that the human immunodeficiency virus does affect the audio-vestibular pathway. There was a significant incidence of audio-vestibular dysfunction in both study groups compared to the controls. There was no significant difference between the HIV seropositive asymptomatic patients and patients with AIDS. The majority of the patients had no otological symptoms.