Women with HIV (WWH) face a heightened risk of cervical cancer and sub-optimal viral suppression. Although mental health conditions and substance use are known barriers to cervical cancer screening and viral suppression among WWH, little is known about the impact of specific mental health symptoms and substance use issues in reproductive-age WWH. This cross-sectional study examined the associations among depression and anxiety symptoms, substance use, cervical cancer screening, and viral suppression in a cohort of reproductive-age WWH enrolled in the Florida Cohort Study. Of WWH (