性行為感染愛滋病毒感染者知會性伴侶之決策過程

The Decision-Making Process of Sexual Partner Notification among Patients Acquired HIV Infections through Sexual Contacts

白芸慧(Yun-Hui Pai) ； 柯乃熒(Nai-Ying Ko)

《台灣公共衛生雜誌》 33卷5期 (2014/10) Pp. 530-547

https://doi.org/10.6288/TJPH201433103018

摘要

目標：愛滋感染者可藉由知會性伴侶，協助其檢測感染情況、獲得治療並減少危險性行為發生，以降低愛滋病毒的傳播。本研究目的為了解愛滋病毒感染者知會性伴侶決策過程。方法：採紮根理論研究法，於南部某醫學中心感染科門診，以理論性抽樣選取13位於診斷前後擁有性伴侶，且曾發生危險性行為的愛滋病毒感染者進行深度訪談，並以ATLAS.ti 5.0版進行持續比較分析法分析文本。結果：知會決策理論架構中，察覺知會伴侶的重要性是愛滋感染者在知會伴侶前的先驅階段，感染者透過評估個人、伴侶層次與愛滋污名脈絡來決定「知會意願」，並擬定知會策略，包括對象、方式、內容、時間及所需協助，實際執行伴侶知會之後，再根據知會後結果評價，修改後續知會意願及策略。結論：伴侶特性及愛滋污名是影響知會意願及知會策略的關鍵。醫療人員可藉此協助感染者釐清知會過程的擔憂，並針對伴侶關係、反應及不同知會階段提供個別協助以擬定知會策略。

關鍵字

愛滋病毒感染者 ； 知會伴侶 ； 紮根理論

並列摘要

Objectives: Notifying the sexual partner of a HIV-seropositive patient enables that partner to be aware of their HIV status, gain early access to treatment, reduce risky sexual behaviors, and prevent the transmission of HIV. The purpose of this study was to understand the decisionmaking process in the notification of the sexual partners of people living with HIV. Methods: Grounded theory was utilized to build the theoretical framework for the process of sexual partner notification. Theoretical sampling was applied to recruit 13 participants who had risky sexual behaviors before and after the diagnosis of HIV. In-depth semi-structured interviews were conducted with each participant and data were analyzed using the constant comparative method by ATLAS.ti 5.0. Results: Awareness of the importance of informing the partner was the first step in the decision-making process. ＂Intent-to-notify＂ was assessed according to individuals, couples and the stigma of AIDS in the context of the relationship. Information strategies were then developed to include the recipient/ the partner to be informed, information methods, content, time and assistance needs. After the actual partners were notified, individuals with HIV re-evaluated their intent or strategies to notify according to the consequences of their experiences with partner notification. Conclusions: Characteristics of the partner and HIV-related stigma were two key issues that influenced the decision-making process of partner notification. Health professionals can assist patients in developing strategies to inform partners in accordance with their individual needs.

並列關鍵字

people living with HIV/AIDS ； partner notification ； grounded theory

參考文獻

衛生福利部疾病管制署： HIV/AIDS 統計月報表。http://www.cdc.gov.tw/professional/info.aspx?treeid=3f2310b85436188d&nowtreeid=2285b9745a0a3cbb&tid=58114AFB86117F53 。引用 2013/02/12 。 Centers for Disease Control, Ministry of Health and Welfare, R.O.C. (Taiwan). HIV/AIDS monthly statistics. Available at: http://www.cdc.gov.tw/professional/info.aspx?treeid=3f2310b85436188d&nowtreeid=2285b9745a0a3cbb&tid=58114AFB86117F53. Accessed February 12, 2013. [IN Chinese]

CDC. HIV partner counseling and referral services: guidance. Available at: http://www.cdc.gov/hiv/resources/guidelines/pcrs. Accessed August 10, 2008.

CDC. Deciding on a PCRS plan and setting priorities. Available at: http://www.cdc.gov/hiv/resources/guidelines/pcrs/pcrs_plan. Accessed August 10, 2008.

Brewer, DD(2005).Case-finding effectiveness of partner notification and cluster investigation for sexually transmitted diseases/HIV.Sex Transm Dis.32,78-83.

CDC(2004).Using the internet for partner notification of sexually transmitted diseases-Los Angeles County, California, 2003.MMWR Morb Mortal Wkly Rep.53,129-31.