Illness is commonly invested with considerable stigma because of its tendency to evoke charged meanings around corporeality, selfhood, suffering, and mortality. Perhaps more than any contemporary disease HIV/AIDS has served as a powerful signifier for a range of cultural anxieties. Given the resultant stigma, HIV becomes very much a question of visibility. This article explores the visibility of HIV within the Sydney gay community with reference to lipodystrophy, an unusual process of fat redistribution caused by HIV therapy that manifests in a series of distinctive body shape changes that have come to signify HIV socially. Conceived through the cultural lenses of AIDS, medicine, illness, and body image, lipodystrophy is largely constituted as negative and shameful, as Other in the ethnographic domain. I examine how this conception is reproduced and contested in narratives and experiences among HIV-positive gay men who have lipodystrophy. Their stories suggest diverse "ways of seeing" lipodystrophy that reveal an ambivalent potential of visibility not only as a medium of stigma, differentiation, and discrimination but also as a medium of affinity, empathy, and desire. These localized patterns of illness visibility are explored in relation to the circulation of meanings within a broader social sense and their significance in terms of a more general consideration of representational practices and their social and ethical implications, with specific attention given to educational and media representations of HIV/AIDS in Australia and also in the United States.