"It's time … to end everything": Discontinue medication choices and narratives among elderly HIV-positive Yi women

Elderly Yi women living with HIV have long been caught between the burdens of family responsibilities and the constraints of local medical management policies, which should be considered. Based on an ethnographic study of these people in a mountainous region of southwestern China, this study employs the narrative disruption approach of Narcofeminism to examine their disease narratives and drug-related decisions-particularly their choice to discontinue medication-within the intersecting contexts of health, family duties, and ethnic medical policies. Our findings note that the decision to stop antiretroviral treatment is largely driven by shifting life meanings and expectancies. Specifically, the completion of family obligations and the intensification of stigma within their villages diminish their sense of future possibilities. In addition, HIV control policies in Yi areas, and the structural distribution of HIV treatment drugs gradually erode their sense of meaning in life. As a result, participants adopt a stance of "frustration and relief" toward their condition, framing the discontinuation of treatment as an autonomous choice rather than a matter of drug adherence and resistance. This study critically reflects on the role of autonomic life visions, especially a sense of the future and meaning, in shaping treatment choices. It expands the discourse on drug choices beyond biomedical frameworks, foregrounding the diverse and autonomous decisions of individuals from a cultural perspective. By centring participant-driven narratives over health-centred scripts, this research also offers recommendations for more contextually informed HIV treatment and drug management policies.