Shattered assumptions: time and the experience of long-term HIV positivity.

This paper elucidates one of the main existential problems faced by people living with an HIV positive diagnosis-the disruption in their routine orientation towards time and the way in which this has the capacity to affect their lives more generally. Drawing upon research with people who have been living with an HIV positive diagnosis for at least five years, the paper aims to illuminate the "provisional existence" imposed upon the individual by the diagnosis and suggests that this ambiguous position underpins the many psychological and social problems confronted by them. In addition, however, the paper argues that in order for the individual to adjust effectively to living with an HIV positive diagnosis, it is necessary for him/her to develop alternative ways of conceiving and living within time, which "compensates" for the loss of the temporal assumptions that existed prior to diagnosis. The various ways in which individuals manage to do this are documented in this paper, as is the failure to do so and the psychosocial consequences ensuing from this. It is further argued that the ability to achieve compensatory temporal understanding is related to the individual's more general "existential orientational framework", of which temporal perspective is a constituent component. Finally, the implications of such findings are discussed for the targeting of appropriate intervention strategies.