In regions of sub-Saharan Africa where HIV is highly prevalent, HIV-affected couples require multipurpose prevention technologies (MPTs) to enhance their reproductive healthcare options beyond contraception and prevention of HIV and sexually transmitted infections (STIs). HIV-affected couples are living longer, healthier lives and are requesting options that will include assistance in becoming pregnant and establishing a family. These couples face unique challenges that require access to specialized information and reproductive services to prevent STIs or HIV transmission while attempting pregnancy. The male condom is the oldest and least expensive available MPT that effectively prevents HIV, STIs, and other STI-related sequelae, including infertility. Furthermore, when couples attempt pregnancy, the unique characteristics of the condom allow it to be used in conjunction with safer conception interventions during the fertile period of the menstrual cycle. The condom may be used with the following: timed intercourse and self-vaginal insemination with or without pre-exposure prophylaxis. Therefore, HIV-affected couples with an immediate desire for a child may use the condom as an MPT, and during the fertile period, the couples may choose either a clinical or pharmacological method in their attempts to achieve pregnancy. Innovative MPTs need to combine methods and technologies in order to assist HIV-affected couples in maintaining their reproductive health, to prevent HIV/STI transmission, and to achieve their reproductive goals of having healthy children when desired. The traditional view of the condom serving only as dual prevention of pregnancy and HIV/STIs needs to be reconsidered, and instead expanded to include its ability to address all disease prevention and reproductive needs of HIV-affected couples. Future designs for MPT methodologies that do encompass the multiple aspects of HIV/STI prevention and reproductive needs may impact MPT demand, uptake, acceptability, and adherence.