This report examines the consequences of a positive HIV diagnosis upon the reproductive decision-making of 39 men and women in Scotland. Whilst the majority initially decide never to have any (more) children this sometimes changes as other factors gain ascendancy, such as a partner wanting 'their' child, and about one-third had had a child or were intending to do so. The motivations underlying such decisions are discussed and ways in which health services could intervene to support people with HIV in making reproductive choices and to minimise the risk of transmission to an HIV-negative partner and the child are suggested.