With improved access to treatment for people living with HIV, many are now able to live longer. As a result, there is growing interest in overall quality of life issues. In many countries, attention is increasingly being drawn to the unique and often neglected needs of different sub-groups, including young people. This exploratory qualitiative study sought to examine the sexual and reproductive health (SRH) needs, concerns and barriers to accessing related services for adolescents aged 10-19 years living with HIV in Zambia. It discusses findings and makes recommendations.