This article describes current nursing practice for pregnant women with HIV. In the United States, the number of new cases of HIV continues to rise in women of childbearing age. Women often learn of their HIV status when a pregnancy involves them in the healthcare delivery system. Since the manifestation of the disease in 1981, there have been significant advances in treatment, and now, among pregnant women testing positive for HIV, the risk of perinatal transmission can be decreased to 1% with pharmacologic intervention. Yet, HIV disease poses many new challenges to the woman testing positive who is considering pregnancy or who is already pregnant. The progression of the symptoms of AIDS is similar to the common symptoms of pregnancy; the HIV medications may also cause these symptoms. Adherence to the HIV medication regime is necessary for ongoing viral suppression, for missed doses can initiate drug resistance and the whole categories of antiretroviral drugs may become ineffective. Additionally, the HIV stigma continues to impact those infected and interferes with the access to healthcare. HIV poses a major challenge for the nurse caring for the childbearing woman.