The goal of this study was to examine the relationship between contraceptive method choice and perceptions of HIV and pregnancy risk among women at risk of HIV infection and transmission.Women who were infected with HIV or who were at high risk of infection were administered a questionnaire assessing sexual and drug-related HIV risk behaviors and beliefs, STD and pregnancy history, and intentions, beliefs and behaviors regarding pregnancy, childbearing and contraception.Among women who reported using a contraceptive method every time they had intercourse, 43% used condoms only, 22% used birth control pills only, and 11% used both. Only 58% of consistent condom users believed they were very unlikely to become infected with HIV in the next year. Controlling for risk factor differences, pill-only users were less likely to believe themselves at risk of HIV infection, and more confident in their ability to prevent HIV infection, compared with condom-only users.Results suggest that women's beliefs about the effectiveness of a method for pregnancy prevention may generalize to beliefs about the efficacy of the method for disease prevention.This study was conducted to explore the relationship between contraceptive method choice and perceptions of HIV and pregnancy risk among women at risk of HIV infection and transmission. To that end, questionnaires on sexual and drug-related HIV risk behaviors and beliefs, sexually transmitted disease (STD) and pregnancy history, and intentions, beliefs, and behaviors on pregnancy, childbearing, and contraception were given to 924 women with HIV or at high risk of infection from 4 cities. Of women who reported using a contraceptive method during every episode of sexual intercourse, 43% used condoms only, 22% used birth control pills only, and 11% used both. Only 58% of consistent condom users, however, believed that they were very unlikely to become infected with HIV in the next year. Moreover, compared to condom-only users, pill-only users were less likely to believe themselves at risk of HIV infection and were more confident in their ability to prevent HIV infection. These findings suggest that when women believe that a contraceptive method will effectively prevent pregnancy, they may also generalize that the method will effectively prevent the sexual transmission of disease. For women who believe thus and rely upon the contraceptive pill to protect themselves against both unwanted pregnancy and STDs, urgent sex and health educational interventions are called for. It should be made clear to women what the contraceptive pill does to protect against STDs and that condoms, when used properly and consistently, reduce the risk of both unwanted pregnancy and STD transmission.