Issues of treatment compliance and the relationship between treatments, optimism and sexual practice are best understood when living with HIV is conceptualized as a dynamic process requiring individuals to work on their subjectivity. In an interview study of 76 people living with HIV/AIDS in Australia, three 'modes of subjectification' were identified: HIV as identity, HIV as experience and HIV as career. The impact of treatments on individuals was mediated by the relationship of HIV to selfhood and to community, and took different forms under each mode of subjectification. HIV as identity was most characteristic of gay men and resulted in failures of compliance or of safe sex being felt as failures of the self. HIV as experience was particularly characteristic of women and heterosexual men and was associated with a less regimented view of treatment compliance and no association between treatments optimism and sexual practice. HIV as career, characteristic of both gay men and others, was associated with hyper-compliant treatment practice and context-dependent sexual practice.