Male partner uptake of HIV testing during antenatal care is poor despite women's reported desire for partner testing. This qualitative study of HIV-negative pregnant women and their partners in a high HIV prevalence city in the United States assessed communication between partners about HIV testing. Facilitators and barriers of partner testing were identified. Women are the driving force behind couples' communication; however, male partner uptake is underutilized. A common barrier to male partner uptake is the concept of "negative by proxy," as well as male partner lack of follow-up for testing and nondisclosure of results. Future research is needed to assess specific barriers to male partner HIV testing as an approach to preventing perinatal HIV transmission.