Paper short abstract:

Biomedical prevention is heralded as the 'game changer' in HIV. In this paper, we draw on findings of a qualitative longitudinal study to examine long-term positive people's experiences of social death arising within the contemporary biomedical HIV landscape.

Paper long abstract:

As biomedical prevention is heralded as the 'game changer' to 'end HIV/AIDS', it is important to consider how diverse communities of people living with HIV grapple with discursive constructions of HIV citizenship, embedded in policy which increasingly focus on biomedical solutions. In this paper, we draw on Mendenhall's (2012) conceptualisation of syndemic suffering, the interactive relationship between forms of violence, social suffering and chronic disease, to examine long-term positive people's experiences of social death arising within the contemporary biomedical HIV landscape.

This paper draws on findings from the Living Positive in Queensland study, a qualitative longitudinal study of aging, place and social isolation involving in-depth interviews conducted over three time periods (commencing 2013) with 72 participants aged 35, who live in rural and regional Queensland. We explore how participants grapple with long term complex health issues, economic marginalisation, structural vulnerability and precarity arising from shifting HIV policy, funding cuts and the dismantling of psychosocial services. We conclude that the focus on biomedical prevention has the potential to reinforce and create new forms of social death by neglect, particularly among early generations of people living long- term with HIV. Policy makers and service providers must recognise that both chronic social/structural issues and chronic health conditions influence health and well-being and the social must be reimagined to negate the slow death by neglect emerging among some people living long-term with HIV.