This article employs the rite of passage concept to analyze why and how heroin use and a subsequent HIV/AIDS epidemic have taken hold among minority Nuosu (Yi) young men in Southwest China. It juxtaposes structural inequalities and sociocultural particularities in social suffering among Nuosu youths as they attempt to create meaningful lives in China’s market reform era. Since the 1980s, young Nuosu have ventured out to Han-dominant cities in search of fun and opportunities. This movement has become a new foray into manhood and inadvertently set up their encounter with heroin and the subsequent introduction of HIV into their hometowns. The article is based on my 20-month ethnographic fieldwork in Limu, a mountainous Nuosu community in Liangshan Yi Autonomous Prefecture, Sichuan Province, between 2002 and 2009.