This paper synthesizes the rates, barriers, and outcomes of HIV serostatus disclosure among women in developing countries based on 17 studies. Barriers to disclosure included fear of accusations of infidelity, abandonment, discrimination, and violence. The low rates of HIV serostatus disclosure reported among women in antenatal settings have several implications for prevention of mother-to-child-transmission of HIV programs. This article discusses these implications and offers some strategies for safely increasing the rates of HIV status disclosure among women.