Among 1022 adults with either pneumococcal bacteremia or meningitis, 85.5% of women and 74.7% of men were infected with human immunodeficiency virus (HIV). A multivariable regression analysis found more pediatric serogroups/serotypes (odds ratio [OR], 1.59 [95% confidence interval [CI], 1.18-2.15]) and more penicillin-nonsusceptible strains (OR, 1.65 [95% CI, 1.06-2.59]) in women than in men; it was also found that bacteremic women were more likely to be infected with HIV (OR, 1.85 [95% CI, 1.26-2.71]) and to be younger (OR, 1.72 [95% CI, 1.25-2.36]) than were men. Thus, conjugate pneumococcal vaccination of children may reduce, in particular, both antibiotic resistance and the burden of conjugate vaccine serotype pneumococcal disease in young, HIV-infected women.