In this study, we explored whether men with HIV (MWH) with unmet reproductive goals in rural Uganda have different sexual behaviors or HIV care engagement compared to men with met reproductive goals. We posited men with unmet reproductive goals would report more partners, condomless sex, and STIs; decreased engagement in HIV care; and have more HIV-RNA viremia compared to men with met reproductive goals. We recruited 100 MWH in Uganda who reported condomless sex with intent to conceive, half had/had not fathered a child in the last year, defined as ”met”/“unmet” reproductive goals. A questionnaire assessed demographics, sexual and health behaviors, and socio-structural factors hypothesized to associate with the outcomes of prevalent detectable HIV-RNA or syphilis, gonorrhea, or chlamydia infection. We also conducted qualitative in-depth interviews in Uganda with 30 MWH who desired more children and self-reported no partner pregnancy after 12+ months of conception attempts. We separately interviewed 10 female partners. Interviews explored stigma experiences and factors impacting engagement in HIV and reproductive care. We used vignettes to elicit responses to stories of couples experiencing challenges of HIV and subfertility.