HIV as uncertain life

Expanded access to antiretroviral therapy (ART) has significantly transformed the HIV/AIDS epidemic. As evidence of this shift, the global health community increasingly classifies HIV as a chronic condition, akin to diabetes and heart disease by emphasizing that it can be managed through testing, drug provision, and behavioral change. While expanded access to treatment is a laudable accomplishment, this representation obscures the underlying conditions for those living with HIV, especially within resource-constrained settings in the Global South. Chronic HIV is a stabilization of life, while managed HIV is an uncertain lived experience. This article reports the findings from research that is examining the social and environmental impacts of HIV/AIDS in rural South Africa. I argue that while those living with HIV know their disease status, this does not mean they know the status of their health. Health uncertainties are generated by a variety of factors, ranging from fluid and unstable viral loads, lingering social stigmas, distinct bodily responses to treatment, and local treatment protocols that do not always align with global prescriptions. The consequence is that while HIV is increasingly classified as a chronic condition, managed HIV is uncertain life that is experienced through inequities in exposure, treatment, and management.