Human papilloma virus is the most common cause of cervical cancer worldwide, and Romania, has the highest rate of cervical cancer in Europe. Sixty-five young Romanian women infected with HIV during early childhood and 25 control subjects were evaluated for the presence of cervical human papilloma virus infection and for cytologic abnormalities. Human papilloma virus infection was evaluated longitudinally in 42 HIV-infected individuals. Overall 28/65 (43.1%) of HIV-infected and 8/25 (32.0%) of uninfected subjects were infected with human papilloma virus, and 21/65 (32.3%) and 6/25 (24%) had high-risk subtypes respectively. In HIV-infected women, those maintaining or acquiring a new subtype in follow-up were more likely to have a lower nadir (p = 0.04) and current (p = 0.01) CD4 counts. The incidence rate for human papilloma virus acquisition events was 0.69 per subject per year, and 0.52 for high-risk subtypes. In the HIV-infected group, 9/13 (69.2%) individuals with abnormal cytology (69.2%) progressed at follow-up. Although human papilloma virus prevalence was similar to controls, the rate of Pap smear abnormalities was much higher, possibly due to the decreased ability to mount new immune responses. Given the high rate of incident detection of vaccine preventable strains and cytologic progression in this cohort, human papilloma virus vaccination may be beneficial at any age in co-infected women.