Little is known about parenting in the context of HIV and psychosis, two co-existing conditions affecting many mothers in South Africa. In this study a mixed methods approach was used to firstly do qualitative investigation of the illness and parenting experiences of a case group of mothers living with HIV/AIDS and psychosis (n = 41). Secondly, the support networks of this group are compared with a control group of mothers with HIV/AIDS without psychosis (n = 44). Integrating qualitative and quantitative data highlight the emotional and physical disruption experienced by the case group that contribute to dysfunctional mother–child interactions. This experience may be detrimental to the child’s well-being and formation of attachment relationships. Healthy support networks may buffer these adversities. The availability of support figures is similar between the groups, but the case group has less spousal support. Paranoia associated with the case group predicted fewer support figures, thus emphasizing the vulnerability of this group of mothers and children.