後疫時代人類免疫缺陷病毒醫療照護者需具備的照護思維

2020年橫掃全球的新冠病毒，讓全球體會了傳染病的重大負面影響，也重新讓醫療照護人員思考疾病照護的烙印。在台灣人類免疫缺陷病毒（HIV）感染者經由高效能抗愛滋病毒治療之後，目前已是一種慢性病。由於感染HIV病毒與行為相關，感染者常被以負面形象呈現，承受多重刻板印象及愛滋污名。在台灣HIV感染者之污名深受東方哲學儒家文化的影響，使感染者面臨的污名情形與西方文化有所不同。目前HIV的治療觀念是病毒量測不到等於不會傳染（Undetectable=Untransmittable, U=U），故在後疫時代HIV醫療照護人員應該具備有實證的照護思維，本篇文章介紹儒家思想下的HIV污名、HIV U=U的治療概念及後疫時代HIV醫療照護人員該具備的照護思維，期盼能提供給HIV感染者無歧視的醫療照護，讓台灣能儘早達成聯合國愛滋病規劃署2030年對全球愛滋病防治零歧視、零感染、零死亡的三零的願景。

關鍵字

愛滋污名；人類免疫缺陷病毒

並列摘要

The COVID-19 pandemic that swept the world in 2020 has highlighted the dangers and challenges posed by infectious diseases and encouraged healthcare providers to further re-think the stigma of epidemic and pandemic diseases. HIV infection was reclassified as a chronic disease in Taiwan after highly active antiretroviral therapy was introduced in the country. Because HIV infection is related to behavior, people living with HIV are often affected by a negative social image that is influenced by multiple stereotypes and the general stigma toward AIDS. In Taiwan, this stigma is deeply influenced by Eastern philosophy and Confucian culture, making the context and effect of stigma different from Western countries. The current "U=U" concept of HIV treatment holds that someone under treatment for HIV with an undetectable HIV viral load cannot sexually transmit the virus to others. Therefore, in the post-pandemic era, HIV medical care personnel should apply evidence-based-care thinking. This article describes HIV stigma in the context of Confucianism, U=U as the leading concept of HIV treatment, and the recommended approach to care for HIV healthcare practitioners in the post-COVID-19 era. Reducing HIV stigma will enable Taiwan to achieve the 'Three Zeros' of zero discrimination, zero infection, and zero death advocated by the Joint United Nations Program on HIV/ AIDS for ending the AIDS epidemic by 2030.

並列關鍵字

HIV stigma ； human immunodeficiency virus

參考文獻

丁志音、李芳盈、方啟泰（2013）．醫師對愛滋病照護經驗、知識及態度的變遷：1994及2012年調查之比較．台灣公共衛生雜誌，32（5），435–448。[Ting, L. C.-Y., Li, F.-Y., & Fang, C.-T. (2013). Evolving HIV-related clinical experiences, knowledge, and attitudes of physicians: A comparison of 1994 and 2012 survey. Taiwan Journal of Public Health, 32(5), 435–448.] https://doi.org/10.6288/TJPH2013-32-05-03

余嘉惠、邱奕頎、鄭夙芬、柯乃熒（2018）．愛滋感染者的污名與靈性照護．護理雜誌，65（3），11–16。[Yu, C.-H., Chiu, Y.-C., Cheng, S.-F., & Ko, N.-Y. (2018). HIV stigma and spiritual care in people living with HIV. The Journal of Nursing, 65(3), 11–16.] https://doi.org/10.6224/JN.201806_65(3).03

莊苹、劉仲冬（1997）．愛滋風暴—愛滋之烙印對感染者及一般民眾之意義．護理研究，5（1），52–64。[Chuang, P., & Liu, C.-T. (1997). AIDS storm: The stigma of HIV/AIDS means to the client and the public. Nursing Research (Taiwan), 5(1), 52–64.] https://doi.org/10.7081/NR.199702.0052

Bavinton, B. R., Pinto, A. N., Phanuphak, N., Grinsztejn, B., Prestage, G. P., Zablotska-Manos, I. B., Jin, F., Fairley, C. K., Moore, R., Roth, N., Bloch, M., Pell, C., McNulty, A. M., Baker, D., Hoy, J., Tee, B. K., Templeton, D. J., Cooper, D. A., Emery, S., ... Opposites Attract Study Group. (2018). Viral suppression and HIV transmission in serodiscordant male couples: An international, prospective, observational, cohort study. The Lancet. HIV, 5(8), e438–e447. https://doi.org/10.1016/S2352-3018(18)30132-2

Bogart, L. M., Cowgill, B. O., Kennedy, D., Ryan, G., Murphy, D. A., Elijah, J., & Schuster, M. A. (2008). HIV-related stigma among people with HIV and their families: A qualitative analysis. AIDS and Behavior, 12(2), 244–254. https://doi.org/10.1007/s10461-007-9231-x

主題瀏覽