The political response to the crisis of HIV/AIDS in South Africa has been notoriously slow and chequered during the late 1990s and early 2000s. A sustained literary response, alert to the impact of the disease has been even slower, although this gathered pace by the mid-2000s in South Africa. This article investigates a number of these significant literary representations in relation to the understanding of HIV/AIDS in the South African public sphere. It focuses upon the ways in which representations of HIV/AIDS raise semiotic and political complexities, the problem of granting or denying sympathy, issues of literature’s attention to silences and differences, especially regarding those who have been culturally marginalized, and the ways in which HIV/AIDS is linked to changing representations of gender in South Africa. It seeks to demonstrate that, no longer constructing HIV/AIDS sufferers as dying subjects for whom nothing can be done, these literary narratives engineer a symbolic reorganization of subjectivity in the public sphere. Literary representations form part of a body of texts that are exhorting more transparency in public debate, demonstrating ways in which people can take greater responsibility for their health, and representing ordinary citizens as subjects with social, political, and psychological power and agency to alter their “life roles”. The article examines the ways in which this symbolic reorganization of subjectivity not only reflects but also projects a change in socio-medical power relations within South African society. Building a social responsibility, imagining new forms of citizenship, and creating new spaces for social justice, such literary narratives demonstrate a narrative transition from a depressed, debilitating doom to a new defiant defence; and in so doing, contribute to a transformative intervention in the public discourse of HIV/AIDS.