靜脈注射毒癮者對於愛滋病快速唾液檢驗法接受度之研究

A Study to Acceptance of Intravenous Drug Users in Taking Rapid Saliva Test for HIV/AIDS

林秀琴(Hsiu - Chin Lin)

指導教授 ： 呂淑妤博士

臺北醫學大學/公共衛生暨營養學院/公共衛生學研究所/碩士(1999年)

摘要

西元1981年美國疾病管制及預防中心，正式公布第一位愛滋病例後，愛滋病已成為全球最嚴重的公共衛生難題。從各國有關愛滋病之研究發現，靜脈注射毒癮者為感染愛滋病高危險群體之一，且其感染人數日益增多。本研究共分兩大部份，第一部分引用民國八十六年「靜脈注射毒癮者對愛滋病防治教育及衛生服務之需求評估」之研究資料進行統計分析。該研究之對象取自北部地區法務單位及醫院戒治單位之靜脈注射毒癮個案，進行面對面訪談。而其主要目的在於探討靜脈注射毒癮者對愛滋病的認知、態度與對愛滋病快速唾液檢驗新法之接受度，有效樣本共279位。第二部分以該研究之醫院樣本進行電話訪問，用以探討共用針頭/針筒行為之原因，共完成有效樣本20人。 研究結果顯示：樣本有關對愛滋病知識答對率近七成六，曾經有共用針頭/針筒行為者佔52％，對於「愛滋病快速唾液檢驗法」之接受度達九成以上。樣本對於愛滋病快速唾液檢驗器材可接受之費用範圍從新台幣200元 至1,000元不等。有四成的受訪者希望政府對此器材應至少補助百分之五十以上的費用，且認為理想販賣此器材之地點為一般藥房，最有效的廣告方式為透過電視台宣傳。 經由路徑分析法分析樣本有關愛滋病知識、態度之影響因素，結果發現「愛滋病知識」與「教育程度」（β＝0.18，p<0.01）達統計上顯著意義；即教育程度越高者，其愛滋病知識較佳。而「愛滋病知識」與愛滋病「信念」（β＝0.15，p<0.01）及「態度」（β＝0.13，p < 0.04）亦達統計上顯著意義；即愛滋病知識較佳者，認為靜脈注射毒癮者比一般民眾得病的機率高，也較不害怕與愛滋病人生活及工作。另外，以對數複迴歸分析法分析之，結果顯示「愛滋病知識」（β＝0.21，p< 0.05）與「婚姻狀況」（β＝－0.94，p<0.04）兩個變項與「愛滋病快速唾液檢驗法」之接受度有相關並達統計上顯著意義；亦即對愛滋病知識較佳及單身狀態（如未婚、離婚或鰥寡）者，對「愛滋病快速唾液檢驗法」之接受度愈高。而從電話訪談之結果則發現，樣本共用針頭/針筒之最主要原因為節省注射後針筒裡之殘藥量、藥癮發作且無法及時取得注射器材、無法及時取得消毒之注射器材等，且其中高達八成的人使用未消毒的針頭／針筒，而共用針頭/針筒的對象為熟悉的朋友及性伴侶。 本研究之結果，期能提供衛生機關在設計靜脈注射毒癮者特殊群體之愛滋病防治教育與篩檢服務之參考。

關鍵字

靜脈注射毒癮者 ； 快速唾液檢查 ； 共用針頭/針筒行為

並列摘要

The number of Acquired Immunodeficiency Syndrome (AIDS) and Human immunodeficiency virus (HIV) infected cases have been rapidly increasing since the Centers for Disease Control and Prevention announced the first AIDS case in 1981. Intravenous drug users (IVDUs) are at high risk for HIV infection. This study was based on two major parts: (1) a secondary analysis of materials drawn from a preliminary survey in 1997 (N=279)；and (2) a follow-up telephone survey designed, carried out and analyzed by this author in 1998 (n=20). The preliminary survey was aimed at investigating the knowledge, attitude, and behavior regarding HIV/AIDS prevention among the IVDUs, and assessing their willingness and acceptability of Rapid Saliva Test (RST) for HIV/AIDS. The main purpose of the follow-up study was to explore the needle-sharing risk behavior among the IVDUs. The preliminary survey included 279 IVDUs from medical and probation institutions. Face-to-face interviews were conducted by using a structured questionnaire that included measurements of HIV/AIDS related knowledge, attitude and behavior. Social marketing model was used to assess the acceptability of RST in terms of 4 P''s: product, price, promotion, and place. Results of this study indicated that the average correct rate for HIV related knowledge was 76%. Roughly 52% of the subjects reported ever sharing needles with someone while injecting drugs. Over 90% of the subjects indicated that the RST is more acceptable than the blood test for HIV/AIDS. The ideal price of the RST kit ranged from NT$200 to NT$1000 according to subjects'' economic status. More than 40% of the subjects were expecting to receive at least 50% subsidy from the government. Drug store was considered as the most appropriate and accessible place to sell the RST kit. Television was the most effective advertisement perceived by the subjects. Results from path analysis revealed that education (β=0.18, p < 0.01) was related to knowledge of HIV/AIDS. Furthermore, subjects with higher level of the knowledge were more willing to take the RST. Results from multiple logistic regression showed that knowledge and marital status were associated with willingness and acceptability of the RST. Findings of the telephone interviews indicated that the major reasons for sharing needles were "less drugs left in the syringe", "needle/syringe was not available when eager to get high", and "unable to obtain clean needle/syringe". The results of this study would be beneficial in designing HIV/AIDS education intervention and developing new HIV screening services among IVDUs.

並列關鍵字

Intravenous drug users, Rapid Saliva Test, Needle-sharing behavior

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