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Despite the effectiveness of the antiviral drug AZT (zidovudine) in reducing perinatal transmission, many HIV-infected women continue to have reservations about taking the medication during pregnancy. To examine the factors influencing HIV-infected women's willingness to take AZT during pregnancy, focused interviews were conducted with 51 HIV-infected women of reproductive age living in New York City. Nearly all the women held reservations about taking it during pregnancy. Barriers to their use of AZT during pregnancy included (a) fear of toxic effects on baby, (b) fear of toxic effects for themselves, (c) fear of drug resistance, (d) belief that AZT is unnecessary among "healthy" women, and (e) previous birth to a healthy baby without using AZT. However, several factors also positively increased women's willingness to take AZT during pregnancy: (a) belief that they owe it to the baby to take AZT, (b) positive relationships with their physician, (c) peers or friends have taken AZT during pregnancy, and (d) previous experience taking AZT during pregnancy. These findings suggest significant areas for intervention to increase the use of AZT during pregnancy, thereby reducing perinatal transmission.