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12 to 2.52], but this effect was mitigated on overall PTB [risk ratio (RR) 1.31; 95% CI 0.92 to 1.86] owing to a protective effect against provider-initiated PTB. HIV reduced the risk of preeclampsia (RR 0.32; 95% CI 0.11 to 0.91), which strongly predicted provider-initiated PTB (RR 17.92; 95% CI 8.13 to 39.53). The timing of antiretroviral therapy start did not affect the relationship between HIV and PTB. The risk of HIV on spontaneous PTB seems to be opposed by a protective effect of HIV on provider-initiated PTB. These findings support an inflammatory me