We conducted a comprehensive cross-sectional analysis of total and HIV-speci?c cervical antibody levels in HIV- 1-resistant, uninfected, and infected women in order to examine the role of HIV-speci?c antibody responses in the female genital tract and examine the effect on antibody levels of various epidemiologic factors in this population. Cervical lavages were collected from 272 subjects of the Pumwani commercial sex worker cohort. Total and HIV-speci?c genital tract IgA and IgG levels were measured using an ELISA and correlated with behavioral and demographic factors. No signi?cant difference was seen between cervical HIV-speci?c IgA levels in infected, uninfected, and resistant individuals, nor were any correlations between cervical HIV-speci?c IgA and neutralization capacity or viral shedding seen. We did, however, note increased HIV-speci?c IgA in HIV- negative women with four or more clients per day, and decreased HIV-speci?c IgA in both long-term non-progressors and long-term survivors. These results show that there is not a strong cohort-wide correlation between HIV-speci?c cervical IgA levels and resistance to infection by HIV-1 as previously believed, but there is a correlation between exposure to HIV and HIV-speci?c cervical IgA. Our ?ndings do not preclude the possibility that functional differences in the cervical IgA of HEPS women may play a role in resistance, but argue that HIV-speci?c responses may not be a universal protective factor. They also indicate that resistance to HIV is a complex condition related to more factors than exposure. Further studies of correlates of immune protection in these individuals would be bene?cial to the ?eld.