With the advent of effective medications prolonging life in adults with HIV, aging with this disease is now possible. Now facing the possibility of a longer life span than expected, a person with HIV may express differential growth in their spiritual development due to coping with such a stigmatizing disease. Using qualitative data from interviews and field notes, this study examined challenges and spiritual resources of 18 adults approaching middle- and older age with HIV. From this, a portrait of using spirituality to cope with HIV is presented. Several spiritual expressions of coping were observed and were classified under the following rubrics: streamlining life, belief in the here and now, right behavior, new path, new strength, fellowship, and closer to God. Examples for each of these expressions are provided as they emphasize how such spirituality facilitates coping with HIV, which may encourage successful aging. © 2008 by The Haworth Press. All rights reserved.