To better understand the clinical manifestations of human immunodeficiency virus (HIV) infection in women in Louisiana, we conducted a retrospective review of the records of HIV-infected women who presented to the largest HIV outpatient clinic in Louisiana as well as to a tertiary care university hospital in New Orleans between January 1987 and December 1991. A total of 224 women were evaluated. Gynecologic examinations revealed that 17.5% had cervical intraepithelial neoplasia and that 35% had evidence of candidal vulvovaginitis or colonization. The following conditions were diagnosed among indicated percentages of patients: syphilis, 22.2%; Neisseria gonorrhoeae infection, 7.2%; Chlamydia trachomatis infection, 12.3%; pelvic inflammatory disease, 5.3%; trichomonal vulvovaginitis, 26.9%; genital ulcers due to herpes simplex virus, 16.5%; and clinically evident genital human papillomavirus infections, 16.5%. Both trichomonal vulvovaginitis and syphilis were more common among intravenous drug users. A total of 82 opportunistic processes were observed in 55 women. Pneumocystis carinii pneumonia was the most frequent complication of AIDS, followed by candidal esophagitis and wasting syndrome. Over 85% of women had received a diagnosis of AIDS before death. Gynecologic diseases occurred often in this population; the frequency of AIDS-defining events was similar to that reported previously in the literature.