Although HIV-associated nephropathy (HIVAN) is the most common form of glomerulopathy found in HIV-infected patients, other lesions have been reported. Lupus-like glomerulonephritis is a lesion that presents with diffuse proliferative immune-complex trapping with lupus-like features instead of the usual focal segmental collapsing of the glomeruli seen in HIVAN. We present a case report of a newly diagnosed HIV-positive white man who presented with dyspnea, lower-extremity swelling, and overt proteinuria. Although initially it was presumed he had a congestive heart failure, a kidney biopsy was performed that demonstrated an HIV-associated diffuse proliferative immune-complex trapping glomerulopathy with lupus-like features. This article reviews the differences between HIVAN and lupus-like glomerulonephritis.