The number of male primary caretakers (biological fathers and other men) of HIV/AIDS-infected and -affected children in the United States is substantial, and will increase as more women become infected and die, and more fathers assume parenting responsibilities. Many male primary caretakers (MPCs) are biological fathers, some of whom are infected, living alone with one or more children, caring for other infected and affected children, and without the emotional support of a female caretaker. These MPCs experience anxiety, depression, and grief. In this unique, exploratory needs assessment about the support service needs of MPCs, the authors surveyed 34 service providers that are involved in Title IV programs of the Ryan White Comprehensive AIDS Resources Emergency (CARE) Act. Providers report that MPCs have special needs for emotional support, networking, child care, and parenting skills training that are being addressed only partially, if at all. Providers serving infected and affected children and their families should identify MPCs and address their service needs. More men may succeed as caretakers of infected and affected children if programs gear their services to the specific challenges these men face. Additional research is crucial given the number who can be expected to need these services in the future.