The meeting during which healthcare providers and newly infected HIV+ patients discuss treatment options is a critical stage in patients' care. We describe 10 interactions between healthcare providers and HIV+ patients at two clinics. Two observers coded each of the 10 interactions for the content of the topics discussed and for communication-relevant behaviors. The interactions followed one of two general patterns, according to whether combination antiretroviral treatment was recommended or deferred. Features of the interactions are described. These features include: (1) the presentation of a single-treatment option, (2) a discussion of whether patients have the will to begin therapy and the skills to adhere to treatment regimens, and (3) organizational pressures to include patients in clinical trials.