In Nigeria, most women find out they are HIV positive during pregnancy. They must make decisions about their sexuality, procreation and infant feeding. Their decisions and experiences are impacted by many factors which this qualitative study explored using the PEN-3 Model. Result revealed that most of the women acquiesced to their husband’s sexual demands or risk violence or infidelity. Condoms were used mainly to protect serodiscordant partners. Inconsistent condom use was driven by belief that being on ARV precludes the use of condoms. Desire for children was high mainly to secure their marriage, fulfill maternal instinct and to leave a legacy. However, infertility, miscarriages, preterm births, infant deaths, tremendous pressure to breastfeed and human rights abuse were common. Overall, the study revealed that Women living with HIV/AIDS in Nigeria, had unmet sexual & reproductive health needs. This book is a must read for health, sociology,women and gender studies professionals, as well as for policy makers, human rights activists and qualitative research scholars.