Somerville K, Jenkins CA, Carlucci JG, et al. - Children who initiated second-line ART in the Caribbean, Central and South America network for HIV epidemiology were assessed for their clinical outcomes. Among a total of 672 children initiating second-line ART, researchers commonly observed poor outcomes after starting second-line ART. Virologic failure occurred at a high incidence and was poorly correlated with changing regimens, which was particularly worrisome. They suggest necessity for additional efforts to ensure children receive optimal ART regimens.