<p>Psychosocial dysfunction is a risk factor for treatment non-adherence among children and adolescents. A previous study showed that high scores on the Pediatric Symptom Checklist (PSC) were associated with a history of HIV virologic failure. We assessed whether high scores on the PSC could predict virologic failure in HIV-infected youth. Caregivers of 234 adolescents between the ages of 10 and 16&nbsp;years were asked to complete a PSC at baseline. Elevated PSC scores were associated with virologic failure in the subsequent 6&nbsp;months. PSC scores may help guide resource utilization when viral load monitoring is limited.</p>