This ethnographically grounded “epidemiology” implicates China's liberalized economy in the HIV epidemic among commercial plasma donors in rural central China. It uncovers the pathological confluence of spheres of economic circulations that have created the conditions for value to be extracted not through labor but from human plasma harvested from agricultural producers. This critique has emerged out of, and in turn informed, efforts to forestall the secondary epidemic of AIDS among donors already infected by HIV. The specific history of the production and consumption of blood products in China shows how biotechnology broadly defined can be powerfully refracted by local configurations of economy, technology, and social relations. The ideologically sustained second-order “reality” of benevolent economic imperatives needs to be brought into the critical focus of cultural anthropology.