高風險性的虛擬空間？臺灣男同志使用手機交友軟體的愛滋風險與避險策略

根據臺灣衛生福利部疾病管制署（Taiwan Centers for Disease Control, Taiwan CDC）的統計資料，近年來，臺灣每年新增的愛滋感染者以年輕男性為主，主要危險因子是男性間的不安全性行為。與此同時，社群網站和手機交友軟體等虛擬空間已成為男同志社群中的主要交友管道，取代傳統的公園、酒吧及三溫暖等實體空間。先前的量化研究對於男同志手機交友軟體上的愛滋風險有不同的看法，同樣將交友軟體的使用者與未使用交友軟體者相比，有研究指出前者有較高的愛滋感染盛行率，亦有研究指出相反的結果，與使用者較可能採取降低風險的行為，例如較常使用保險套、進行愛滋篩檢等相關。在這樣看似矛盾的研究結果背後顯示，手機交友軟體為臺灣當代男同志社群帶來了更便捷的交友模式，能夠連結更廣大的虛擬社群的同時，是否也帶來某些隱憂？　　本研究於 2020 年 4 月至 8 月間，透過半結構式深度訪談和參與式觀察，以立意抽樣與滾雪球抽樣的方式招募 15 位男同志手機交友軟體的使用者進行訪談，其中包含 11 位非愛滋感染者以及 4 位愛滋感染者，並在臺北市內使用 Hornet 和 Grindr 兩款交友軟體進行參與式觀察。本研究以「男同志使用手機軟體交友如何增加／減低男同志感染愛滋或遭逢愛滋污名的風險？」作為問題意識，探索以男同志為主的男性間性行為者在交友軟體上遭逢了怎樣的愛滋風險環境？在這樣的風險環境中，男同志有怎樣不同的認知？男同志在使用交友軟體的實作過程中，發展出了怎樣的策略，來面對可能遭遇的愛滋感染風險？愛滋感染者又如何避免交友軟體上的愛滋污名風險？　　本研究的主要發現如下：一、男同志手機交友軟體 Grindr 相較於 Hornet，有較多使用娛樂性藥物的社群，因此使用者發展出的避險策略多與避免娛樂性藥物的使用有關；二、手機交友軟體的即時性和在地性使得性伴侶的配對快速，可能衍生愛滋風險，故使用者傾向於以取得潛在性伴侶的個人資訊和與潛在性伴侶建立關係的策略來降低風險；三、手機交友軟體大多具有標示使用者愛滋篩檢狀態的功能，但該功能的實際效用仍有待商榷；四、即使在手機交友軟體上，受到愛滋污名的影響，愛滋感染狀態的揭露仍然相當不易。　　依據主要發現，本研究提出以下建議：一、發展貼近男同志社群手機交友軟體使用生態的介入方案與政策；二、增進年輕族群對手機交友軟體上娛樂性藥物使用術語的認識；三、以手機交友軟體作為去愛滋污名化的平臺；四、從法律層面減少愛滋感染者選擇揭露感染狀態與否時的阻礙。

關鍵字

男同志；手機交友軟體；愛滋風險；愛滋揭露；愛滋污名

並列摘要

According to the statistical data of Taiwan Centers for Disease Control (CDC), men have been in majority of new cases of HIV infection in recent years. Among them, most cases are at the age of twenties and thirties, and the main risk factor is unprotected sexual behaviors of men who have sex with men (MSM). At the same time, traditional ways of making friends in gay community such as meeting in parks, bars or saunas have been replaced with social networking sites and gay geosocial networking apps. Some quantitative research showed that HIV prevalence was significantly higher among app users than non-app users, while other research showed the opposite results, which might be related to the fact that app-using MSM were more likely to have risk-reduction behaviors such as condom use and HIV testing. The inconsistent results not only implied that geosocial networking apps become a faster and more convenient way of making friends for the contemporary gay community in Taiwan and enable gay to have more connections with a vast virtual community, but also implied the apps might cause some potential problems. Nevertheless, in the process of using apps, what strategies are developed when they face possible risks? This research aimed to explore HIV risks and strategies of the users of gay geosocial networking apps and to answer the main question about “how the usage of geosocial networking apps as a way of socializing in gay community increases or decreases HIV infection/stigma risks?” The research was conducted through in-depth interviews and participatory observation, from April to August, 2020. Purposive sampling and snowball sampling were used for the interviews of 15 users of gay geosocial networking apps, including 11 HIV-negative and 4 HIV-positive participants. Participatory observations of two apps, Hornet and Grindr, were also made in Taipei. The main results were as follows: (1) More users of recreational drugs gathered on Grindr than Hornet, and thus the risk-reduction strategies from users were mostly associated with avoidance of recreational drug use. (2) Immediacy and locality were characteristics of apps, which resulted in faster matching made between sex partners and might cause higher HIV risks, and therefore the users tended to obtain personal information from and build relationships with potential sex partners to reduce HIV risks. (3) While apps mostly had the function of labeling the HIV status of users, the effect of the function was still unknown. (4) Disclosure of HIV-positive status through usage of apps was still not easy due to HIV stigma. The research finding suggested: (1) developing intervention programs and policies close to the experiences of using apps among gay community; (2) increasing the knowledge of terms of recreational drug use on apps in young gay community; (3) using apps as platforms to destigmatize HIV; (4) reducing barriers to disclosing HIV status for HIV-positive apps users from a legal perspective.