The relationship between posttraumatic growth (PTG; perceiving positive changes since diagnosis) and disease status, determined by changes in viral load and CD4 count over time, was examined among 412 people living with HIV. In controlled multiple regression models, PTG was not associated with disease status over time for the entire sample. However, there were significant associations for certain subgroups. PTG was positively associated with CD4 counts for Hispanic participants (vs. non-Hispanic) and those with low (vs. high) levels of optimism. PTG was inversely associated with viral load among those low (vs. high) in pessimism. Although PTG was inversely associated with depressive symptoms, alcohol, and illicit drug use, these factors did not account for the findings.