1 2 3 in utero 4 4 5 6 7 + 8 13 4 14 4 4 15 16 17 3 3 17 21 3 Pre-test discussions regarding risk reduction for HIV infection are not a requirement for HIV testing and can be provided in the context of discussions of reproductive health and STD prevention. Routine HIV testing during preconception care can be integrated with other aspects of preconception care that require a blood sample and should not require substantial additional time commitments by providers. Improved implementation of preconception care will further extend the success in reducing perinatal HIV transmission in the U. S. as well as improve access to HIV testing and care to women. Because the issues accompanying HIV treatment during pregnancy and perinatal prophylaxis are rather complex, the case for preconception counseling and care for known HIV-infected women is clear.