Patients with HIV who desire or have indications for diagnostic testing during pregnancy (e.g., abnormal ultrasound or aneuploidy screening) should be counselled about the potential risk of perinatal HIV transmission, along with other risks of the procedure, so that they can make informed decisions about invasive testing. Although the data on women who are receiving current ARVs are limited, the risk of perinatal HIV transmission does not appear to increase with the use of amniocentesis or other invasive diagnostic procedures in women who have virologic suppression on ART. Prior to effective ART, invasive procedures, such as amniocentesis and chorionic villus sampling, were associated with a twofold to fourfold increase in the risk of perinatal transmission of HIV. Patients ideally should have undetectable HIV RNA levels at the time of the procedure.