The aim of this study was to investigate whether immune system impairment in infancy remains associated with lower NAA and Cho in the basal ganglia at age 7 and at age 9 in an expanded group from the same cohort studied by Mbugua et al. (2016). Because increased basal ganglia Cho and NAA in HIV+ children who initiated ART before 12 weeks was attributed to the use of primarily HEU controls (Mbugua et al., 2016), we aimed to compare HIV+ children to HIV-unexposed controls. In addition, although some studies report neurocognitive deficits in HEU children (Van Rie et al., 2008; Kerr et al., 2014), none have investigated the effects of perinatal HIV and ART exposure on neurometabolite levels in childhood. Our second aim therefore, was to investigate differences in basal ganglia neurometabolite levels between HEU and HIV-unexposed children (controls) at ages 7 and 9.