To access this article, click on "Additional Links" and wait till the publisher's website provides a free version.Our objective was to assess the mental health status of pregnant women who are HIV-positive, compared with other groups of pregnant women. We evaluated pregnant HIV-positive women attending the Medecins Sans Frontiers (MSF) HIV clinic in Malanje, Angola (N = 23). The control group consisted of pregnant women coming for antenatal clinic consultations who were not known to be HIV-positive (N=134). To assess mental health, the 12-item General Health Questionnaire (GHQ-12) was used. A score of three or greater was considered to indicate significant emotional distress. We also examined determinants of emotional distress in logistic multivariate regression models. We found that the mean score on the GHQ-12 for the HIV-positive group was more than twice the mean score of the controls, indicating poorer mental health in the HIV-positive group. Two-thirds of HIV-positive women had significant emotional distress, more than twice that in the control group. As well as HIV status, marital status was a strong independent predictor of mental health status, with married women experiencing less emotional distress. Thus, in our sample, pregnant women who were HIV-positive had a much poorer mental health status than the controls. Strategies to improve the mental health of HIV-positive mothers must be implemented and evaluated; efforts to decrease the levels of stigma and discrimination in this population are of key importance.