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Patients' Ways of Speaking About Antiretroviral Medications and Possible Implications for Adherence

The medical literature reports that antiretrovirals (ARVs) are considered attitudinal objects (Dunbar-Jacob, 1995). Drawing on the pragmatics of emotion (Caffi & Janney, 1994), this study analyzes how patients' stances about their ARTs shape their emotional relationships with their treatments. The data, collected in a public hospital in Uruguay, are analyzed by means of qualitative (Halliday & Matthiessen, 2004) and quantitative methods. For several reasons, patients do not always report directly when their adherence to ARTs is suboptimal, but pharmaceutical adherence is essential for their survival. This study suggests that patients' emotional adherence might be anticipated by their linguistic choices used to refer to ARVs. It is observed that emotional alienation from the ARTs is expressed either by overt (e.g., devil terms) or covert linguistic choices related to a non-ego, non-hic, or non-nunc perspective. The implications for medical providers are in developing awareness of their patients' linguistic choices in talking about ARTs, since emotional (non)adherence might anticipate pharmaceutical (non)adherence.