Clinic of a tertiary referral hospital in Pretoria, South Africa were included through convenience sampling. Patients were interviewed, medical files were reviewed and clinical examinations, including otoscopy, tympanometry, pure tone audiometry and distortion product oto-acoustic emissions, were conducted. An age, gender, working-environment and race-matched control group were compiled and hearing loss prevalence were compared.Results: Tinnitus (26%), vertigo (25%) hearing loss (27.5%), otalgia (19%) and ear canal pruritis (38%) were prevalent self-reported symptoms. Abnormalities in otoscopy, tympanometry and otoacoustic emissions were evident in 55, 41 and 44% of patients respectively. Pure tone average (PTA) hearing loss >25 dBHL was evident in 14% of patients and 39% for hearing loss >15 dBHL (PTA). An increase in self reported vertigo, self reported hearing loss, OAE abnormalities and hearing loss (PTA>15dBHL and PTA>25dBHL) was seen with disease progression but was not statistically significant. A significant increase (p<.05) in sensorineural hearing loss was evident with disease progression. Significant differences were found between the average thresholds in the test and control group throughout the frequency spectrum.Conclusions: Auditory and otological symptoms are common in patients with HIV with a general increase of symptoms, especially sensorineural hearing loss, towards advanced stages of disease progression.