Participating in and working for HIV interventions is both a source of both pride and suffering for many men who have sex with men (MSM) who engage in low-paying sex work in Kenya. Drawing on ongoing intermittent ethnographic research conducted among MSM sex workers since 2010, we analyse the relationship between hope and resilience on one hand, and narratives of suffering and hustling on the other. We show how HIV technologies that provide spaces for visibility and mobilising, such as new treatment regimes, accompanying support groups and training programmes, as well as activist led organisations, allow MSM sex workers to contribute to national and global HIV responses with a sense of both pride and shared suffering. We argue that pride, suffering and hustling are central to male sex workers' identity, solidarity and resilience. Attempts to build resilience among MSM sex workers and other highly marginalised people at continued risk for HIV would be advised to take their complex ambivalences towards health and rights-based interventions into account.