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  • 學位論文

監所內藥癮收容人感染愛滋病毒危險行為之性別差異研究

Gender difference of HIV risk behavior among intravenous drug users in the prison

指導教授 : 江宏哲
共同指導教授 : 蔡季君(Jih-Jin Tsai)

摘要


研究背景與目的: 根據衛生署疾病管制局愛滋病統計發現,臺灣地區近年來靜脈注射藥癮愛滋感染者人數快速增加。從2003年82位案例至2006月已有1778位毒癮愛滋感染者。而這幾年毒癮愛滋新發生案例中,約有63%是來自監所受刑人或收容人。因此監所是一個接觸靜脈注射藥癮者的重要管道。本研究主要目的為比較性別差異對靜脈注射藥癮者感染愛滋病毒危險行為之影響,並預測監所內靜脈注射藥癮者感染愛滋病毒之可能危險因子。 研究方法: 本研究採用橫斷式研究法(cross-sectional study),以屏東監獄和高雄女子監獄的靜脈注射藥癮收容人為研究對象,以半結構式問卷進行資料收集,問卷內容包括:基本人口學資料、藥物使用行為、性行為、憂鬱程度及愛滋病相關知識態度等五大部分。 研究結果: 本研究總共收集了163位靜脈注射藥癮HIV感染者(男性有103人;女性有60人)和315位靜脈注射藥癮非HIV感染者(男性有220人;女性有95人)進行資料分析。監所內女性藥癮收容人在多重性伴侶(p=0.011)、藥物使用方式(p<0.001)、共用針頭頻率(p=0.008)、使用藥物時間(p=0.019)、配偶同為藥物使用者(p<0.001)、憂鬱程度(p=0.001)和愛滋病相關知識方面(p=0.002)與監所內男性收容人有統計學上顯著的差異。研究結果發現影響監所內靜脈注射藥癮者感染HIV的相關危險因素為「藥物使用方式」(OR=22.782;95%CI=3.14~165.46;p=0.002)、「保險套使用頻率」(OR=9.99;95%CI=1.39~71.47;p=0.022)、「共用針頭頻率」(OR=19.91;95%CI=3.09~128.12;p=0.002)及「有多重性伴侶」(OR=22.782;95%CI=3.14~165.46;p=0.002)。 結論: 性別在感染HIV相關危險行為是會造成影響,女性比男性在性行為方面更顯的被動,但女性其固定性伴侶亦是藥物使用者的機率顯著高於男性;而在藥物使用行為方面男女在使用方式及使用種類有所差異,因此未來在進行衛生教育時應該分別就性別差異進行輔導,同時也必須針對靜脈注射藥癮非HIV感染者衛生教育,包括保險套使用及正確清潔針具等相關知識。政府單位亦須加強推動減害計畫的施行,以減低靜脈注射藥癮族群感染HIV之機率。

並列摘要


Objectives: According to Taiwan CDC AIDS statistic data, the number of HIV infected intravenous drug users has increased rapidly in recent years. In 2006, 1,778 newly diagnosed HIV infected IDUs were reported, compared with 82 in 2003.However, in recent years newly diagnosed HIV infected persons, 63% were incarcerated IDUs. Hence the prison is an important channel to contact IDUs. The objectives of this study were to compare gender difference of HIV risk behaviors, and investigate HIV risk factors among IDUs in the prisons. Methods: A cross-sectional study was conducted.Subjects included IDUs in a male and a female prisons in southen . Using semi-structued questionnaire to collected the information. The questionnaire content includes: the demography data, the drug use behavior, the sexual activity, the depression degree and the AIDS KAP (knowledge, attitude, and practice). Result: A total of 477 participants, including 163 HIV infected IDUs (male:103, female:60) and 315 IDUs(male:220, female:95), were enrolled in this study. Incarcerated female IDUs had significant difference than male IDUs on multiple companion (p=0.011), the drug-using way (p<0.001), share needle frequency (p=0.008), the drug-using period (p=0.019), having IDUs companion (p<0.001), depression degrees (p=0.001) and the AIDS related knowledge (p=0.002). In logistic regression, significant risk factors of HIV infection among IDUs included “drug-using way” (OR=22.782;95%CI=3.14~165.46), “condom using frequency” (OR=9.99;95%CI=1.39~71.47), “share needle frequency” (OR=19.91;95%CI=3.09~128.12;p=0.002)and “multiple companion” (OR=22.782;95%CI=3.14~165.46). Conclusion: Gender is an important factor of influencing HIV risk behavior. The female IDUs were more passive which reveals in the sexual activities than the male IDUs. But female IDUs its constancy companion also is the drug user probability is being higher than the male IDUs. However, it also has a difference in the drug use behavior among male and female, like the use way and use type. Therefore future health education will be separately to counseling on gender difference. Simultaneously also will have to aim at the IDUs non-HIV infected group health education, including condom use and the correct clean needle. The government must strengthen the force on harms-reduce plan, in order to decrease the probability of hiv infected among IDUs group.

參考文獻


參考文獻
1. 衛生署疾病管制局, 新聞與活動-澳洲藥癮愛滋防治專家來台分享減害成功經驗. 2005年12月15日.
2. UNAIDS, G., UNAIDS and WHO:AIDS Epidemiology Update. December 2006.
3. 方啟泰、熊秉荃、游正芬、陳茂源、王榮德, 如何設計一份特定疾病所適用之生活品質問卷-以愛滋病患為例. 台灣醫學, 2002. 6(2): p. 215-19.
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