Drawing from 18 months of ethnographic fieldwork in one urban and one rural setting in Swaziland,
involving 13 case studies of adolescents living with HIV, in this article we explore the meaning of the
family as it applies to Swazi adolescents’ everyday life. Our findings suggest that the meaning of the
family is constantly evolving and transforming based on changing needs of, and expectations by,
adolescents in different contexts and moments of the care continuum. Central to the meaning of
the family is a strong desire for belonging – that is, being accepted, welcomed and appreciated.
Traditional institutions that used to regulate where children belong still shape adolescents’
perceptions, hopes and desires, but may also prevent their realisation. Support groups are
important but do not substitute for the familial belongings adolescents living with HIV have lost,
and long for. Policymakers, programme managers and health providers working with
adolescents living with HIV need to embrace the complexity and dynamism of the meaning of
family and base their policies, programmes, standards and guidelines not only on the factual
care arrangements that adolescents find themselves in, nor on legal definitions of rights and
responsibilities, but also on what adolescents want.