To determine the prevalence and type of hearing disorders in HIV positive patients not on anti - retroviral drugs (ARVs) and correlate this with the world health Organization (WHO) stage of HIV disease and CD4 positive cell counts.Case control study.Comprehensive Care Clinic (CCC) and Voluntary Counseling and testing centre at Kenyatta National Hospital.One hundread and ninety four HIV positive patients attending CCC and 124 HIV negative subjects recruited from voluntary counseling and testing (VCT) centre.Hearing loss (HL) was present in 33.5% of HIV positive compared to 8.1% in negative subjects. No gender bias in HL Sensorineural hearing loss (SNHL) was the most common and the frequencies most 'affected were four-anti eight kHzHearing loss is more prevalent in HIV positive individuals not on anti-retroviral drugs than negative normal subjects. Low CD4 cell count and advanced HIV diseases were associated with increased chance of having a hearing loss. Otological care should be part of the comprehensive care of HIV positive patients.