Based on fieldwork in the city of Kisumu, Kenya, the paper examines the survival of HIV positive people on antiretroviral medicines and situates this within broader moral economies of their lives – in matters of food, hunger, social relationships and networks of care, including NGOs. Through locating survival at the level of individual adherence to medication, antiretroviral programs medicalize it. Yet their focus on the intimate relation between medicine and food also opens up spaces in which the material conditions of life can be articulated. The paper follows these spaces, from the clinic to the economy of NGO interventions and community-based groups, paying attention to how hunger and material needs are visible in some spaces and invisible in others, and to how people have learned to articulate their “needs”. In this economy, HIV identities accrue moral and economic value, as through them people become visible to the flow of funds and the distribution of goods organized by NGOs.