Cognitive anthropological methods are used to explore a shared cultural model of self-managing HIV/AIDS among poor HIV-positive women who are not receiving biomedical treatment in Nairobi, Kenya. This model includes basic needs and eating a balanced diet to maintain health. Women know the importance of a balanced diet and rate this as the most important for staying healthy. Their competence in the model is compared to length of time they have lived in Nairobi, level of NGO involvement, and how long they have known their HIV status. Kenya is an ideal place to investigate social and cultural factors that affect the health of HIV-positive women because of the ethnic diversity, high rates of unemployment and poverty, HIV/AIDS prevalence, gender inequalities, and rural-to-urban migration. HIV-positive women in Nairobi face many problems, especially in managing their illness in the absence of biomedical treatment. Many have migrated to the city from rural areas. As they adjust to changes, they may be unable to access resources, including those that help with basic needs. This article focuses on understanding how women in sub-Saharan Africa manage their illness in these extremely marginal conditions from a biocultural perspective and provides a description of this model.