Abstract
Adherence to medicines tends to be envisaged as a matter of actors' reasoned actions, though there is increasing emphasis on situating adherence as a practice materialised in everyday routines. Drawing on the qualitative interview accounts of Black African women living with HIV in London, UK, we treat adherence to HIV medicines as not only situated in the practices of the immediate and everyday but also relating to a hinterland of historical and social relations. We move from accounts which situate adherence as an embodied matter of affect in the present, to accounts which locate adherence as a condition of precarity, which also trace to enactments of time and place in the past. Adherence is therefore envisaged as a multiple and fluid effect which is made-up in-the-now and in relation to a hinterland of practices which locate elsewhere.
Highlights
We draw on the qualitative interview accounts of Black African women living with HIV in or near London, UK, to explore practices of adherence to HIV antiretroviral drugs (ARVs)
Our analysis has situated adherence to HIV medicines at once as a matter of practice in relation to the immediate and everyday situation and as an effect of a hinterland of socio-m aterial practices which enfold the past, through elements of time and place, into the present. We have made this analysis through the stories of three women, whose accounts we use to illustrate how broader themes of embodiment, precarity and migration entangle in relation to adherence practices
Our aim is to attend to adherence as matter beyond reasoned action to accentuate the materiality of doing adherence in-the- illustrating how embodied adherence locates in relation to the time and place of the present as well as in relation to a hinterland of precarity linked to migration
Summary
We draw on the qualitative interview accounts of Black African women living with HIV in or near London, UK, to explore practices of adherence to HIV antiretroviral drugs (ARVs). Our aim is to draw attention to how adherence to medicines is situated in the practices of the immediate and everyday, and relates to a ‘hinterland’ of broader historical, political and geographic relations (Law, 2004). While the delineation of ‘practical barriers’ draws attention to adherence decisions and actions as effects of how individuals navigate their immediate social environments, it neglects attention to the wider complex of human and non-h uman elements which entangle to make-u p adherence potentials, including how the immediate adherence present locates to a broader hinterland of history, geography and politics. Our focus is individual human subjects, and their reasoned or situated actions, and the material relations which bring various elements together in the adherence assemblage (Duff, 2014; Fox & Alldred, 2017). To how the adherence that is embodied in-the- of the everyday locates elsewhere (Callon & Law, 2004)
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