Children living with HIV should be diagnosed as early as possible and linked to antiretroviral treatment. The costs of HIV virological testing, individual and social implications of the disease require critical quality of the medical approach to diagnostic strategy. Socioeconomic data can be used to refine the medical decision. The objective of this analysis was to determine informative capacity of socioeconomic indices in the diagnosis and approach of HIV in severely malnourished children using receiver operating characteristic (ROC) curves. Materials and Methods: This was a test performance analysis conducted from data of severely malnourished children at an inpatient feeding therapeutic center in Ouagadougou. Anthropometric and social indices have been used as tests; their sensitivity, specificity and predictive values have been calculated. ROC curves and areas under curves were obtained. Medical decision aid scheme has been validated from severely malnourished children data. Results: Socioeconomic indices showed high performance to discriminate severely malnourished HIV infected and uninfected children, with high area under ROC curves. The medical decision aid scheme specificity reached 97.6% with predictive values close to 85%. Conclusion: This approach can help for expanding ART for children in low income countries and achieve the maximum ART benefits in child socioeconomic kneed context.