The purpose of this qualitative study was to develop a clearer understanding of the challenges and needs of long-term HIV=AIDS survivors living in rural and semirural areas, as well as to explore what factors and resources may be related to more effective coping. Eleven long-term HIV=AIDS survivors were invited to participate in this research through an AIDS service organization working in rural= semirural California towns. Each participant was interviewed using structured questions. The interviews were transcribed and analyzed using ATLAS.ti. Spirituality, having a sense of control, and social support were associated with more positive perceptions. Perceiving life as ''better'' or ''worse'' seemed unrelated to prediagnostic functioning for the majority of the participants. Coping seemed to have more to do with individual reactions than to actual life circumstances, health, or financial status. Interestingly, some of the most ill with the most limited incomes expressed the most optimistic perceptions of their lives. Similarly, while it was expected that persons living in rural areas would have more difficulties, the majority of our participants did not seem to perceive living in rural or semirural areas as barriers to services. A surprising finding was the number of participants who noted the stigma of disability related poverty as being more important than the stigma of having HIV=AIDS, being a homosexual, or having a mental illness.The authors would like to thank the participants for sharing their experiences. To the larger population of persons living with HIV=AIDS, we applaud your courage and inspiration to persevere despite physical, emotional, social, spiritual, and economic challenges.