AIDS is a major cause of death in sub-Saharan Africa and for many social reasons coming to terms with AIDS-related loss is complicated and difficult for bereaved young people. Yet, understanding of African AIDS-bereaved young people’s perspectives about their grief and perceptions of adults (health professionals and carers) about the young people’s reactions to loss is under-developed. This qualitative study therefore explores the emotional reactions of AIDS-bereaved young people and social factors that help or hinder their ability to cope with loss by comparing the similarities and differences between the perceptions of bereaved young people, their carers and professionals working with them. Individual open-ended interviews were carried out with ten carers of the young people and six professionals. Twelve individual open-ended interviews and a single focus group discussion were conducted with AIDS-bereaved young people aged between 15 and 18 years whose parent died of AIDS three to five years before this research. These were tape recorded and transcribed in full and the subsequent data analysed using constant comparative method. Key findings are that bereaved young people react to their loss with a range of emotions and that adults and young people differ regarding their perception of the intensity of their reactions. Many examples of differences in perception were identified, including young people’s view that they were overwhelmed by their loss while the adults, on the other hand, believed that they were coping with their loss. Young people wished to be told about their loss and to discuss it; however, neither the professionals nor carers were involved in such discussion with the young people. Secrecy, stigma, isolation and discrimination experienced by the young people were perceived as unhelpful to their coping; whilst being allowed to talk about loss, the feeling of being listened to, interacting with peers and the addressing of immediate basic concerns were perceived as helpful. Understanding differences in perceptions between AIDS-bereaved young people and the adults around them appears to be the first stage in developing strategies to create an enabling environment for the young people. In addition, building the capacity of carers and professionals working with the young people to acknowledge their loss, understand their reactions and establish effective communication with them is an essential aspect of helping them to cope with their loss.