Introduction: Sayana Press, a subcutaneous formulation of depot medroxyprogesterone acetate (DMPA) prefilled in a Uniject syringe, could potentially improve and expand contraceptive injection services, but acceptability of Sayana Press is unknown. HIV-positive women have a particular need for family planning to avoid unintended pregnancy and risk of vertical transmission. We assessed acceptability of Sayana Press (SP) versus intramuscular DMPA (imDP) among HIV-positive women and their care providers in Rakai, Uganda. Methods: Women were randomized to imDP or SP at baseline, received the alternate product at three months, and chose their preferred method at six months. We determined preferences among new and experienced contraceptive injectable users who had experienced both types of injection during the trial, and from providers before and after providing both types of injectables to clients. Results: Among 357 women randomized, 314 were followed up at 6 months (88%). Although SP caused more skin irritation than imDP (3.8% vs. 0% at six months), it was associated with marginally fewer side effects (30.4% vs. 40.4% at six months). Willingness to recommend the injection to a friend, and satisfaction with the injection received increased dramatically over time, but did not differ by injection type. Nearly two-thirds of women (64%) and three-fourths of providers (73%) preferred SP to imDP; women’s preferences did not differ by previous experience with injectable contraception. Conclusions: SP appears to be acceptable to HIV-positive women and health care providers in this population.