Background Very few published studies have dealt with the management of locally advanced cervix carcinoma among HIV-positive patients. The objective was to compare the clinical characteristics, radiation and chemotherapy treatments, and outcomes in a cohort of HIV-positive and –negative women with cervical cancer. Methods We reviewed the charts of 59 HIV-positive patients and 324 HIV-negative patients with stage IBi – IIIB cervical carcinoma, who received radiation therapy. We compared demographic and clinical characteristics at diagnosis and radiation dose, chemotherapy cycles, and response at time of brachytherapy and six-week follow-up. We developed logistic regression models of response to treatment. Results 49 (88.1%) of the HIV-positive patients but only 213 (65.7%) HIV-negative patients presented with stage IIIB disease (p=0.009). 47 (79.7%) HIV-positive patients and 291(89.8%) HIV-negative patients completed the equivalent radiation dose of 68Gy EBRT and HDR brachytherapy (p=0.03). Of the 333 patients who commenced concurrent chemotherapy, 26 (53.1%) HIV-positive patients and 212 (74.6%) HIV-negative patients completed four or more weekly cycles of platinum-based treatment. Follow-up was censured at six weeks. In models that included age, stage, HIV status, and treatment, poor response at six weeks was associated only with having stage IIIB disease (OR=2.39, 95%CI 1.45 – 3.96) and receiving less than 68Gy EQD2 radiation (OR=3.14, 95%CI 1.24 – 7.94). Conclusions HIV-positive patients fared worse than HIV-negative patients due to later presentation and a decreased likelihood of completion of treatment. Our findings emphasise the importance of completing irradiation therapy. Further studies will address the association of these variables with survival.