Little is known about the lives and hardships of socially marginalized and economically destitute women in rural Central China living with human immunodeficiency virus (HIV), who acquired the virus through commercial blood and plasma donations in the mid-1990s. Women living with HIV and acquired immune deficiency syndrome (AIDS) experience significant economic hardships and social exclusion in a male dominated, traditional, rural Chinese society, including the loss of labor power, financial burdens, and HIV-related stigma. This qualitative study examined strategies used by these marginalized women to cope with these hardships. Thematic analysis was used to analyze data from 15 interviews from women in Fuyang City, Anhui. Findings reveal that women undertook a variety of coping strategies: migrating to smaller towns, reducing labor intensity, reallocating labor within households, supplementing incomes by taking on additional jobs, borrowing money from relatives, reducing food consumption, lowering standards of living, withdrawing children from school, strategically disclosing HIV status and background information to employers, as well as avoiding weddings or funerals. This study identifies policy implications that can be used by social workers to mitigate the deleterious social and economic impacts of HIV and AIDS on the lives of women in vulnerable rural households in central China.