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Globally, the number of women living with HIV who desire pregnancy has been increasing and little is known as what motivates them, with test and treat women accessing ART desiring pregnancy will increase. Kakamega County has been leading in the region on women living with HIV accessing antenatal services. Past literature in the subject matter failed to look at socio-cultural and societal factors influencing pregnancy among HIV positive women in Kakamega County, Kenya; a gap that informed this study. A descriptive cross-sectional research design was employed. The target population were women aged 18-49 years receiving their family planning services in sub-county hospitals in Kakamega County. Key informants were made up of health care workers at comprehensive care clinics. Purposive sampling was used to select 4 sub-county hospitals, systematic random sampling to select 319 known HIV positive women and 4 focus group discussions. Questionnaires focused on group discussions and key informant interviews were used to collect data. Data collected were entered into Statistical Package for Social Sciences version 25.0. Descriptive results were presented in proportionate tables. The results showed that age, education, employment status and parity influenced the desire for pregnancy among HIV positive women in Kakamega County. Society influenced the number of children a woman should have. The community held a negative perception of childless women, especially HIV positive women; the community members did not attach value and pride over the childless HIV positive women. The socio-cultural and societal demand on HIV positive women influenced pregnancy; however, there decreasing association, which meant that the society was 71% less likely to influence the number of children; the spouse was 63% less likely to influence pregnancy. In conclusion, age, education level, marital status parity and employment status, medical cover influenced pregnancy among the known HIV positive women in Kakamega County. Socio-cultural and societal demands were predictors of pregnancy among known HIV positive women in Kakamega County. The community should treat HIV positive women with respect and dignity, thus permitting them to continue their family legacy and sire children. It recommends that there is a need for the county government, department of health services to provide health education to the community on stigma reduction and discrimination meted on these women and negative perception of childlessness women in the society especially known HIV positive women. Further works on the myths and misconception that barrenness is blamed on women leaving men scot-free for the cloud to be the culprits of childlessness in the family.

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