The discourse of the reproductive rights of HIV positive women tends to focus on the active right to bear children as opposed to refraining from childbearing as a choice. True, the right of HIV positive women to bear children is sacrosanct, and thus merits the attention given in academic or other spheres. However, the right of HIV positive women not to bear children or being railroaded into involuntary motherhood is likewise important and deserves paramount attention. In the context of sub-Saharan Africa, this article engages this comparatively less-well addressed aspect of the reproductive rights discourse. With access to contraception, safe abortion and related services as reference points, the article addresses the compelling need for an effective and sustainable structure to facilitate the meaningful enjoyment of reproductive rights by HIV positive women, whichever direction they choose to exercise the rights.