Primary care for women with human immunodeficiency virus (HIV) disease is appropriately provided by nurse-midwives within a well-coordinated system of medical consultation and referral. The issues of access to care, partner notification, reproductive choice, and breast-feeding are discussed. The nature of the collaborative management of HIV in pregnancy is explained. Management issues include the effects of HIV infection and pregnancy upon each other, perinatal transmission risks and postpartum needs, family planning, and gynecologic needs. Clinical care guidelines are included.