Objective:Most data published on adolescents with HIV (AWH) have been collected before the large diffusion of second-generation integrase strand transfer inhibitors (INSTI) among the pediatric population. We analyzed the nationwide ANRS-MIE CO10 Pediatric cohort to assess the changes over time in health and social outcomes of French AWH.Design:The cohort enrolled children born in France since 1985 and, from 2005, children diagnosed with HIV at ≤13 years, including those born abroad if antiretroviral-naive at first medical care in France.Methods:Adolescents aged ≥10 years at their last visit were included in this analysis. Their characteristics were compared between three periods of birth (1985–1993, 1994–1999, 2000–2010).Results:Overall, 529 AWH were included. Their median age at first HAART initiation decreased from 94 to 29 months (P < 0.0001). At the last evaluation, the proportions of AWH receiving HAART, receiving INSTI, having HIV-RNA < 50 copies/mL and having CD4 count ≥500/μl increased over time (P < 0.0001), reaching 98·7%, 53.3%, 81.3% and 85·0%, respectively, for those born in 2000–2010. The proportion of maternal and paternal orphans decreased until 14.4% and 11.0%, respectively, for AWH born recently. Compared to middle adolescents (15–17 years) born in 1994–1999, those born in 2000–2010 demonstrated higher academic success (69·2% versus 42·3%) and less frequent academic failure (4.6% versus 6.2%).Conclusions:Despite spectacular improvement in their health and immunovirological status, AWH remain vulnerable compared to other French adolescents, with a higher risk of being orphan and/or experiencing academic failure. Specific interventions are required to improve their global quality of life.