In this qualitative pilot study, distress and strengths associated with aging with Human Immunodeficiency Virus (HIV) were identified for 12 participants. Potential sources of distress were fear of death, financial worries, fear of disclosure, stigma, and long-term coping. Strengths were hardiness, renewed spirituality, social support, community service, and openness to aging. Ways of mitigating these barriers and accentuating these strengths can be explored by mental health professionals if extended with a representative larger sample. © Psychological Reports 2005.