From Abruption to Chronicity: Temporalities of Long-Term HIV Survival in Norway

Since the mid-1990s, combination antiretroviral therapy (ART) has transformed HIV from a fatal diagnosis into a manageable long-term condition. For the first time, a large cohort of people who once expected to die young are now growing old with HIV. This article examines how long-term survivors narrate and make sense of a life shaped by two linked turning points: First, a diagnosis that was widely understood as a death sentence; and second, the arrival of effective treatment, which abruptly reopened a future that had been foreclosed. Drawing on life-history interviews with 21 people living with HIV aged 50 and older in Norway the article shows that diagnosis was experienced as a terminal rupture that cancelled plans, relationships, and long-term commitments. The subsequent stabilisation of effective therapy did not simply restore what had been lost; it introduced a second upheaval, compelling participants to rebuild a life they had not expected to live. I propose the concept of prognostic horizon reversal to name this therapy-driven shift in expected life horizons and to clarify how it reshapes biography, responsibility and the practical work of planning for a future under conditions of ongoing treatment, clinical monitoring and the lingering traces of earlier crisis.