Background <p>HIV infection could be regarded as a trauma that causes multidimensional distress experiences among people living with HIV. While people living with HIV may also experience positive changes which can lead to post-traumatic growth in the process of struggling with trauma. Current research has neglected the personal experience of people living with HIV, and there is a lack of qualitative research that further explores the dynamic post-traumatic growth trajectory. This study aims to explore and analyze the post-traumatic growth trajectory among people living with HIV to provide a reference for future targeted interventions.</p> Methods <p>A programmed grounded theory-based qualitative study was conducted. Data were gathered using semi-structured, in-depth interviews with 30 people living with HIV in southwest China from April 2024 to May 2024, which were then analyzed and integrated using grounded theory.</p> Results <p>30 interviewees were between 27 and 59 years old, 18 males and 12 females, and their education levels were mainly primary school or illiterate. Trajectories of post-traumatic growth among people living with HIV are viewed as the core category and consist of four phases, which are initial (trauma and stress), support (contemplation and help-seeking), internalization (acceptance and change), and growth (hope and future).</p> Conclusions <p>The post-traumatic growth trajectory among people living with HIV is a complex and dynamic process. Medical staff should dynamically evaluate post-traumatic growth developmental phases and provide individualized psychological interventions to facilitate transitions and transformations between phases and ultimately achieving self-growth.</p>