This article addresses life on antiretroviral therapy in rural Tanzania. It argues that a nuanced understanding of theories of biosociality requires us to take sociality and locality as seriously as we do “bio.” People living with HIV associate on the basis of preexisting social relations, not just on the basis of their biological status. Their CD4 counts do not only measure immunological processes but also index social conditions of hunger. The pharmaceutical that gives them life insists that they eat and rest more than austere financial circumstances allow. Many join HIV groups, but these do not enable the kinds of “citizenship” that have been described elsewhere. Patient activism is stifled by bureaucratic antipolitics mechanisms inherited from postcolonial restrictions on political association. Instead, they enter an NGO economy that values their biological status because they attract income from donors, but does little to enable the living that they need.