African American women are disproportionately affected by HIV. We used a phenomenological approach to understand the experiences of living with HIV in a group of older African American women. Approvals were obtained, and a criterion sample of 10 participants who self-identified as African American were recruited. Data were collected using unstructured interviews. The emergence of seven essential themes resulted in a textual interpretative statement that indicated that the meaning of living with HIV disease for this group of older African American women was (a) the dynamic interrelated patterning processes of transcending adversity and becoming as they responded to their emotional ebbs and flows, (b) being always hypervigilant to HIV stigma, and (c) managing the paradoxical process of concealing while revealing aspects of their lives with HIV. The women used knowledge as empowerment and strove to maintain relationality by caring for others while they, themselves, were being cared for.