Opsonic but not adhesion-blocking activity or total levels of anti-VSA-PAM is associated with protection from anemia in multigravid women with PAM. Multigravid women with malaria were stratified on the basis of maternal Hb levels using the clinical definitions of anemic (Hb levels of <11 g/dl) (closed symbols) and nonanemic (Hb levels of ≥11 g/dl) (open symbols) and on the basis of HIV status (HIV infected [circles] and HIV uninfected [squares]). Data for opsonic activity (A), adhesion-blocking activity (B), and total anti-VSA-PAM (C) are shown. There was no difference in adhesion-blocking activity or total anti-VSA-PAM between groups (P = 0.81 and P = 0.51, respectively, by one-way ANOVA). There was a significant difference in opsonic activity between groups (P = 0.022 by one-way ANOVA), which, in pairwise comparisons, approached significance (after deflating the significance level to account for multiple comparisons) for HIV-uninfected women (P = 0.03 by unpaired t test) but not HIV-coinfected women (P = 0.122 by unpaired t test).