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Clinical observations indicate that human immunodeficiency virus (HIV)‐positive women experience more postoperative problems than do HIV-negative women. To obtain a better estimate of the individual risk of postoperative morbidity among HIV-infected women, and to determine which procedures pose the greatest risk, we performed a retrospective case-control study in which we assessed the outcomes after 235 obstetric and gynecologic surgical procedures. For purposes of comparison, an HIV-negative control patient was matched for each of the 235 surgical procedures performed, on the basis of the type of procedure and patient age. We found a significantly greater number of postoperative complications among the HIV-positive women. Higher complication rates occurred after abdominal surgery (odds ratio [OR], 3.6; ) and curettage (OR, 7.7; P p .001 ). Among HIV-infected women, the risk of complications was associated with immune status. AntiP p .06 retroviral therapy and standard perioperative antibiotic prophylaxis did not decrease the risk of complications. Indications for performing abdominal surgery and curettage on HIV-infected women should be carefully weighed against the potential risk of postoperative complications.

HIV-1-infected women have a considerably increased risk of postoperative morbidity after caesarean sections. We showed that this risk was independent of current antiretroviral therapy.