Author (Your Name)

Margaret Duggan, Colby College

Date of Award


Document Type

Honors Thesis (Open Access)


Colby College. Sociology Dept.




This paper aims to provide a systematic review of the discourse surrounding patient adherence in an effort to illustrate the extent of the problem, how it is framed, and how intervention is currently approached. The paper begins with a general review of adherence, to ground the reader in the current discourse. The next section of the paper will focus specifically on adherence through the lens of HIV/AIDS. Since HIV/AIDS treatment and adherence to antiretroviral drugs is pertinent to adherence issues due to the complexity and lifelong duration of treatment. Furthermore, adherence with HIV/AIDS medications is particularly important due to the high potential for harder to treat, drug resistant strains when drugs are not taken exactly as prescribed. A national survey of 1080 HIV patients discovered that 78% of those with >500 copies HIV RNA/mL had drug resistant virus, and one fifth of treatment naïve patients had resistant virus (Finkelstein 2002). Clearly, drug resistance is a spreading problem, and only makes treatment of HIV/AIDS more difficult. The paper then will move to discuss and analyze non-adherence and targeted interventions in relation to the current marketization of health care. Though less pursued due to the current way of framing discourse, an analysis of the literature on adherence and adherence interventions illustrates that non-adherence is, in part, a manifestation of the troubling direction that the health care system is moving.


Clinical health, psychology, Medical care, United States, Patient compliance, Health behavior

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