There are around 86 HIV-specialist social workers in England. Of around 60,000 people currently living with HIV/AIDS in England, 15% are receiving some form a statutory social care, mainly support from HIV social workers. However, HIV social work has been steadily declining, and the threatened ‘de-ring-fencing’ of the AIDS Support Grant poses a major threat to HIV statutory and voluntary social care. The aim of this research, 21 years after the inception of the AIDS Support Grant, is to examine the specialism of HIV/AIDS social work and the efforts of local authorities to support people with HIV/AIDS. The research involved visits to 16 local authorities in England, chosen to represent different regions, social and demographic characteristics, models of service delivery and levels of HIV infection. It included interviews with HIV social workers, their managers and commissioners, and HIV voluntary workers, observations of visits to service-users, and related background reading. It demonstrates that the most notable feature of HIV-specialist social care across England is its extraordinary diversity, with every local authority area seeming to have arrived at its own highly distinctive set of HIV social care services. Six recommendations for HIV social care are provided.