Transitioning to adulthood is a challenging experience for all young adults, but especially for those who are living with HIV/AIDS and residing in low income, urban areas. Young adults, particularly those who live in low income, urban areas, have the highest rate of new HIV cases among all age groups in the United States. The purpose of this study was to examine the lived experiences of a purposive sample of young adults living with HIV/AIDS who resided in a selected low income, urban area in order to better understand how ecological and health factors presented opportunities and challenges for resilience and coping. This is an important topic because this age group has the highest rate of new HIV cases. Decreasing HIV health disparities is a top priority of the U.S. Office of AIDS Research, the National HIV/AIDS Strategy, and Healthy People 2020. Semi-structured, in-depth interviews were conducted on a purposive sample of 16 young adults 18-29 years of age living with HIV/AIDS from a selected low income, urban area in the southeast region of the United States. Data from the interviews were analyzed for significant statements, meanings, and themes. Major challenges and barriers indicated by the participants included issues related to mental health, stigma and disclosure, relationships, marriage and children, inadequate health/sex education in the schools, lack of HIV/AIDS knowledge in their communities, and medication adherence. Major strengths and supports included internal resilience and positive attitudes, small support networks of family and friends, HIV support groups, and an array of available medical and support services. Participants’ suggestions for improving the lives of young adults living with HIV/AIDS included integrating HIV/AIDS services with other services, enhancing mental health services, particularly at the time of diagnosis, providing assistance when disclosing their HIV status to others, enhancing health/sex education in the schools, increasing community education about HIV/AIDS, using motivational speakers to educate other young adults, creating community resource centers for those living with HIV/AIDS, and conducting more research studies on the topic. This information may be valuable for educational leaders, healthcare leaders, policymakers, and other professionals who design and conduct programs, services and policies to help this group transition to adulthood, care for themselves, and prevent transmission of the virus to others.