This ethnographic research examines the daily life and institutional conditions under which low-income Black women in urban North Carolina perceived and attended to HIV health-related needs. I focus specifically on the interplay among women’s living conditions, programmatic service needs, and their strategies for navigating the local system of care to explore and refine the categorical label “low income.” I found that there were significant differences among study participants in terms of their monthly incomes and financial resources, housing quality and status, and personal experiences with incarceration and substance abuse. The economic differences among women translated into social differences within the context of federally-funded AIDS care programs. Social differences were realized as the differential ability to transform programmatic services enrollment into beneficial social networks. Ultimately, financially stable women were better positioned than their more economically vulnerable counterparts to reap the economic and social benefits of programmatic services eligibility and enrollment. It is in this context that I explore federally-funded AIDS care services as one social field through which processes of class unfold and articulate with processes of race and gender.