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The use of antiretroviral therapy during pregnancy by women infected with HIV has significantly reduced the risk of HIV transmission to the fetus. For women who want children after being diagnosed with HIV, it is possible that this information may have the potential to increase risk taking behavior such as unprotected sexual relations to achieve pregnancy. Few data exist to describe HIV+ women’s sexual and self care practices in relation to becoming pregnant. This study is a secondary analysis of data from a qualitative study of the experience of pregnancy after diagnosis with HIV. Interviews with a purposive sample of 9 mothers, ages 34 to 53, previously diagnosed with HIV were tape recorded, transcribed, and analyzed to describe how the participants negotiated the desire for children with her partner and how risk of transmission to partner and fetus was addressed. Themes of issues with disclosure of HIV status, addressing the risk of transmission, self-care behaviors in relation to the physical self, and self-care behaviors in relation to the spiritual self captured the essence of their experience. Consideration of these themes may enhance the provision of health care to minimize transmission risk and to promote health among HIV infected women planning a pregnancy or to those women already pregnant.