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Background: Little is known in human immunodeficiency virus (HIV)–positive women about how the combination of plasma HIV RNA level and CD4 ⁺ T-cell count is associated with the natural history of human papillomavirus (HPV) infection or about HPV reactivation—whether it occurs and with what frequency in HIV-positive women. Methods: HIV-positive (n = 1848) and -negative (n = 514) women were assessed at semiannual visits (total person-years = 5661) for cervicovaginal HPV with polymerase chain reaction assays and for squamous intraepithelial lesions (SILs) by Pap smear. We studied the prevalent detection of HPV and SILs with generalized estimating equations and the incident detection and persistence of HPV and SILs with multivariable Cox models. All statistical tests were two-sided. Results: We observed a strong interaction between the …