This qualitative study draws on interpretative principles with emphasis on understanding young mothers’ vulnerability to HIV/AIDS and explores coping strategies used to mitigate risk of infection in a poor rural setting of Ghana. Young mothers in their mid-twenties to early thirties and their male partners were purposively selected with the assistance of key informants for repeated semi-structured interviews. Respondents included those in monogamous and polygynous marriages with two or more living children, and those with and without formal education. Young mothers in this study setting are confronted with complex realities as childbearing obligations make protective sex less optional. However, more assertive women insist their husbands use condoms when they perceive themselves at risk. We conclude that the advent of HIV may advance the cause of women’s reproductive health empowerment by providing women with very strong reasons to minimize HIV risk within marriage.