男性間性行為者在公共場域的性行為型態及潛在的性健康風險

Potential Sexual Health Risk among Men Who Have Sex with Men in Public Sex Environments

葉桂君(Kuei-Chun Yeh)

指導教授 ： 丁志音

國立臺灣大學/公共衛生學院/衛生政策與管理研究所/碩士(2009年)

https://doi.org/10.6342/NTU.2009.00770

摘要

目的：台灣男性間性行為者（Men who have Sex with Men, 簡稱MSM）感染HIV的趨勢仍居高不下，由於MSM長期受到社會歧視，使其聚集在MSM專屬的空間尋求認同，形成特殊的公共場域。本研究期望能深入了解MSM在不同公共場域中與性相關的互動型態，以便以場域為管道，發展出針對此族群最有效的防治策略。
方法：本研究從2007年11月到2008年7月，運用質性研究之「面對面深入訪談」、「焦點團體」、「非正式訪談」及「參與觀察」的方法來收集資料，挑選熟知一種或多種MSM公共場域的MSM受訪者，共蒐集18名MSM受訪者的資料。
結果：主要研究結果有(1)公園（公廁）、戲院、男同志三溫暖、健身房、同志酒吧、轟趴和網路，是MSM最常做為社交功能與發生性互動的場域，且上述場域所吸引的MSM族群各有差異，(2)男同志三溫暖與轟趴是最常當場發生性行為的場域，其他場域則是一個性邂逅的管道，提供接下來能到更合適的場所發生性行為的機會，(3)雖然MSM消費場所之經營者的愛滋防治概念已提升，但介入的方式或許不恰當，仍需進一步調查與改善，(4)在公共場域已普遍使用的助性藥物，可能危及安全性行為的實踐，(5)網路不同於一般MSM交友的公共場所，它是一種媒介，提供更迅速能實際接觸的機會，使其風險遠大於其他公共場域。
結論：MSM活動的公共場域相當多樣化，為了性互動目的而形成的設施與空間安排，有潛在的HIV/AIDS或性傳染病風險。然而這些公共場域也是能夠針對MSM族群，做出有效宣導愛滋防治的場域，應該切合不同場域的特色，提供以場域為導向的防治政策。

關鍵字

男性間性行為 ； 公共性行為場域 ； 愛滋防治 ； 保險套 ； 性健康風險

並列摘要

Objectives: Men who have sex with men (MSM) continue to be the predominant group that contributes to the HIV/AIDS epidemic in Taiwan. Due to prevailing prejudice to their sexual identity and, as a result, the social exclusion commonly experienced by them, special “places” have emerged as MSM privileged settings. This study examines sexual related interactions and the pattern of sexual behavior engaged by MSM in different public environments. Potential risks for HIV/AIDS or other STIs which inherent in the context of each place were explored, and, correspondingly, the norms and practices of safer sex like condom use were elaborated. It is expected that findings from this study can inform setting-oriented HIV/AIDS interventions targeting on MSM.
Methods: From November 2007 to July 2008, this qualitative study applies multi-methods to collect data, including face-to-face in-depth interviews, focus groups, informal interviews, and participant observations. The data on which the study is based mainly came from 18 MSM. They were selected because they were familiar with one or more specific types of “gay place.”
Results: The major findings of the study are: (1) the parks (and public toilets), theaters, gay saunas, gyms, gay bars, home parties, and internet constitute the most commonly used venues for general and sexual interactions among MSM. Each attracts different segments of MSM, (2) on-site sexual partnering and exchanges were most likely to happen in gay saunas and home parties. Other environments, however, were used to channel sexual activities in other more suitable or private places, (3) although awareness of HIV/AIDS risks has raised among gay community and those who run the commercial gay entertainment places, certain interventions they applied in the public (sexual) environments were inappropriate and should be further investigated, (4) The increasing use of entertainment drugs in some public environments may greatly jeopardize the intended safer sex practices, and (5) The internet, a unique “public environment” which functions as a powerful medium to connect people in the virtual world and make real sexual contacts soon in the real settings, emerges as a riskier public place than others.
Conclusions: The public environments for MSM activities are quite diversified and spatial arrangements or facilities designed for the purpose of sexual interactions inside these environments have posed risks for HIV/AIDS or other STIs transmission. However, these environments also held potential for effective HIV/AIDS interventions among this group. Greater efforts should be directed to setting- or environment-oriented prevention strategies.

並列關鍵字

men who have sex with men (MSM) ； public sex environments (PSEs) ； HIV/AIDS prevention ； condom ； sexual health risk

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