Wilson KS, et al. - In this prospective cohort study conducted among 255 HIV-positive female sex workers in Mombasa, Kenya, researchers evaluated fertility desire using generalized estimating equations, as a risk factor for semen detection in vaginal secretions by prostate-specific antigen (PSA) test, a biomarker of condomless sex, detectable plasma viral load (VL), and HIV transmission potential, defined as visits with positive PSA and detectable VL. As per observations, fertility desire was noted to be associated with higher risk of biological evidence of semen exposure when women were not using nonbarrier contraceptives. Regardless of fertility desire, low HIV transmission potential suggests the efficacy of the combination of condoms and antiretroviral therapy adherence.