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Readiness for therapy of people living with HIV is of major importance in the process of antiretroviral decision making. This qualitative study is part of a prospective multicentre investigation describing readiness for antiretroviral therapy (ART) and decision making in HIV-infected patients. The qualitative results present the daily experiences of people living with HIV in the treatment decision making process related to starting or changing ART. Based on a critical hermeneutic research design, interviews with twelve persons have been conducted. Two main categories were generated: "dealing with oneself and others" and "understanding and being understood". They describe the dialectical process of decision making with a focus on interactions with others. This process includes four themes: illness beliefs, health perspectives, therapy beliefs, life perspectives. The findings of this study reveal that partnerships of health care providers with HIV-infected patients are necessary for treatment decisions. Moreover; it is of major importance for health care providers to include patients' experiences and expertise and to allow time for the different dialogues.