Male sexuality in Africa is often associated with harmful sexual practices, which, in the context of HIV and AIDS, often positions men as central to the spread of the epidemic. Despite this focus on men's practices, there is a lack of research exploring the subject positions of men living with HIV. This study explores how masculinity is constructed by a group of black South African men who self-identify as heterosexual and are living with HIV. Using discourse analysis, a construction of a normative masculinity is identified as being both idealised and perceived as a burden, in that men continually need to engage in actions that affirm their position as 'real' men. By depicting men as invulnerable and unemotional, this construction limits men from acknowledging health risks or accessing support. A second discourse constructs HIV and AIDS as disrupting normative masculinity, in that it restricts men's agency through illness and the need for care. A final discourse relates to a transformed masculinity, where men living with HIV reconstruct their masculinity, as conforming to normative constructions of male identity is perceived as restrictive and harmful.