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We aimed to establish the prevalence of human immunodeficiency virus (HIV)-associated malignancies in children attending a care and treatment clinic at Kilimanjaro Christian Medical Centre.This was a retrospective cross-sectional hospital-based study of children who attended an HIV care and treatment clinic between 2006 and 2014. Children aged 2 months to 17 years were eligible for participation. The data on social demographic and clinical characteristics were extracted from the medical record. A multivariate logistic regression model was developed to determine predictors of HIV-associated malignancies.Medical records from 721 HIV-infected children were reviewed. The median age (interquartile range) at HIV diagnosis was 5.7 (2.0 to 9.4) years. Among them, 34 (4.7%) had HIV-associated malignancies. The most common (n=24, 70.3%) malignancy was the Kaposi sarcoma. Age at HIV diagnosis was significantly associated with HIV-associated malignancies (adjusted odds ratio, 1.2; 95% confidence interval, 1.0-1.3). Among 34 patients with HIV-associated malignancies, 11 (32.4%) died. Seven (20.6%) patients reported complete remission from their malignancies, and outcomes for 6 patients were unknown.The prevalence of HIV-associated malignancies was high and was associated with late HIV diagnosis. The Kaposi sarcoma was the commonest malignancy. Early HIV diagnosis and treatment in children might reduce HIV-associated malignancies.