Children from mothers with HIV-related psychosis are frequently raised in challenging contexts, yet the extent to which these children grow up in insecure or disordered attachment relationships is unknown. Using the Strange Situation Procedure the distribution of attachment relationships of children from mothers with HIV and psychosis (n = 45) was compared with children from mothers with HIV without psychosis (n = 41). No significant differences in the distributions were found between the two groups and attachment was not associated with specific psychotic symptomatology. Security of attachment was associated with more people providing the mother with emotional support, but only in the psychosis group. Disordered attachment (24%) was more often found in the total sample than in studies with other normal and high risk populations. Recommendations were made for future research about factors facilitating resilience in the children and on interventions increasing emotional support for affected mothers.