ABSTRACT Interpreting the visual and narrative discourse of AIDS in popular culture is pivotal in communication and cultural studies. However, there is a notable research gap concerning the narrative evolution in Chinese AIDS films. This study investigates the shifts in narrative perspectives and visual representations of people living with HIV in Chinese cinema, using conceptual metaphor theory and textual analysis. It identifies a metaphorical transition in societal perceptions of people living with HIV—evolving from “abjection politics” representing them as “criminals” through “compassionate politics” depicting them as “vulnerable” to “touching politics” celebrating them as “heroes.” This transition is intertwined with China's modernisation, mirroring changes in social structures and power relations. The research highlights the relationship between historical context and narrative truth in disease representation by using critical discourse analysis and drawing on Foucauldian power-knowledge concepts. The study reveals how AIDS narratives in film reflect broader socio-political shifts within China's modernising landscape, emphasising the intricate connection between power, knowledge, and disease portrayal. By tracing the discursive evolution in Chinese AIDS films, the research illuminates the dynamics of China's socio-political environment and underscores the multifaceted complexities inherent in disease narratives amidst societal modernisation.