In sub-Saharan Africa, women account for 60% of HIV-
1-infected adults [1]. Many African countries with high
HIV-1 prevalence also have high fertility rates, and
women are pregnant for a substantial portion of their
adult years. Physiologic changes during gestation –
including high levels of progesterone that could induce
systemic or genital mucosal immunologic changes [2,3] –
may increase the risk for women to acquire HIV-1
during pregnancy and pregnant HIV-1-infected women
to transmit to their sexual partners. Unprotected sex
associated with efforts to conceive and continued during
pregnancy may also increase HIV-1 risk