Background. The impact of human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS) on the participation of women in paid/unpaid work is a little understood phenomenon. Purpose. A research study exploring the lived experiences of Canadian women's engagement in paid/unpaid work and the barriers and facilitators mediating this phenomenon. Method. Study design employed a phenomenological approach using data subanalysis of transcripts, double coded for agreement and to ensure saturation of themes. Results. Analysis of the data revealed an overarching theme of engagement mediated by interacting forces with eight subthemes: active management, agency constrained by structure, the nature of supports, HIV/AIDS sequelae, work as a galvanizing force, the presence of children, the element of fear, and negotiation of self. Implications. Insights gained indicate a need for further education, resources, supports, and policy changes at the systems level. Occupational therapy is positioned to broaden the role of rehabilitation in the context of HIV/AIDS, episodic disability, and work participation.