This study assessed medical residents' perceptions of their overall competence to provide primary care to pediatric AIDS patients. On a 7-point Likert scale, residents in pediatric (n=260) and family practice (n=161) training programs across the United States rated their educational preparedness and training experiences in AIDS care in 9 areas. Respondents were predominantly White (74%) and female (53%). completing their 3rd year of training (94%) at a university-affiliated program (87%), with a mean age of 31. Overall, 98% of the residents had treated HIV-infected and AIDS-infected patients. Repeated-measures multivariate analyses of variance were used to identify significant differences between the two specialties on 9 areas of curricular training and two patient age groups (pediatric and adolescent). Perceptions of the residents concerning their preparedness to diagnose HIV and AIDS treat AIDS-related illnesses, treat AIDS patients and their overall level of competence to provide AIDS primary care for pediatric and adolescent patients is discussed. There appears to be a need for further AIDS-related educational experiences in residency training programs.