As the number of women living with HIV continues to increase, the lack of sex-specific data on responses to antiretroviral therapy (ART) becomes increasingly problematic. Establishing the specific needs of women has been hampered by a strong male bias of study populations in clinical trials resulting in a lack of female-specific data for ART. The limited data currently available make it difficult to draw conclusions about the pharmacokinetic profile and clinical efficacy of ART in women. Data relating to the safety and tolerability profiles of ART in women are more plentiful, with indications that women may experience adverse event profiles distinct from those experienced by men. This, in turn, may be a factor in the generally higher rates of discontinuation of ART observed in women. Psychological and social aspects of HIV infection are particularly pertinent for women and girls, presenting potential barriers to diagnosis, access and adherence to therapy. Understanding these factors, in conjunction with an increase in clinical trial and real-world data specific to women with HIV is required to provide clearer guidance on optimum ART options for women.