Data from 49 HIV/AIDS-infected mothers were used to determine how many of their perinatally HIV/AIDS-infected (n = 37) and seronegative (n = 95) children were referred through a county school system in North Carolina to social work and counseling services because of episodes of behavioral crisis in school during the past academic school year. Forty-one percent (n = 23) of these children exhibited behavioral crises, in which the seropositive (n = 12) and seronegative (n = 11) children were nearly evenly split. Externalizing problems were the main precipitators of behavioral crises for both groups of children. However, although the seronegative children were likely to initiate fistfights with classmates or throw objects with the intent to physically harm classmates or teachers, the seropositive children were likely to sexually harass classmates and verbally abuse them or their teachers. Implications for school social work practice and future research are discussed.