In Uganda, the social expectation that women should bear children competes with HIV clinic expectation that HIV-positive women should bear few or none. This contradiction undergirds this thesis, which examines how access to ART, social expectations and clinical expectations all combine to influence how HIV-positive women approach pregnancy in southwestern Uganda. From August to December 2011, ethnographic fieldwork was conducted in Mbarara, Uganda. Semi-structured interviews were conducted with 25 pregnant HIV-positive women accessing ART. The main themes that emerged were that: 1) HIV-positive women reported new optimism about pregnancy since being on ART, 2) adherence to ART and family support helped women manage social expectations placed upon them, and 3) clinic counselling about pregnancy beyond adherence to ART was not common. Thus, ART is an important link between managing social and clinical expectations for HIV-positive women since it improves womenâs health and decreases risks of childbearing.