愛滋男同志使用安非他命焦點民族誌研究

Amphetamine Use in HIV-Infected Men Who Have Sex with Men: A Focused Ethnography

曾嘉琳 ； 莊苹 ； 劉亞平 ； 曾雯琦

《人文社會與醫療學刊》 8期 (2021/05) Pp. 1-26

https://doi.org/10.6279/JHSSM.202105_(8).0001

摘要

台灣愛滋病毒感染之男男性行為者在安非他命類興奮劑的使用情形有日益增加之趨勢。然而，對於安非他命類興奮劑對愛滋病男男性行為者日常生活的影響卻很少有研究進行論述。本文採用焦點民族誌，以參與式觀察、個別訪談、以及焦點團體訪談等方式，探討使用安非他命對感染愛滋病毒的男男性行為而言所代表的意涵、行為模式，以及對他們身體健康行為之影響。研究結果發現參與者因為沈浸於使用安非他命類興奮劑時的親密感和經驗，促使參與者因為要滿足性行為而持續使用安非他命。即使已經察覺對自己的生理及心理造成危害，然而因為外界對愛滋、同志、藥物成癮等污名，使得參與者不敢告訴醫療人員真正的困擾，因而不斷在成癮及戒癮之間徘徊，也發展出特殊的自我照顧身體健康的行為。本研究結果可以提供如何預防此族群使用安非他命類興奮劑，以及幫助愛滋病毒感染的男男性行為者戒癮之實務和政策參考。

關鍵字

安非他命 ； 愛滋病照顧 ； 男男性行為 ； 焦點民族誌

並列摘要

The use of amphetamine-type stimulants(ATS) among HIV-infected men who have sex with men (MSM) have been increasing in Taiwan. However, few studies have been conducted to investigate how ATS influences daily lives among MSM with HIV infection. Thus, the aim of this study was to describe what life was like and how they dealt with psychiatric symptoms among MSM with HIV infection in Taiwan. Focused ethnography was used to describe the meanings and patterns of actions of MSM with HIV infection in an HIV care center. Fieldwork included participant observation, individual and group interviews with 11 MSM with HIV infection. Data from transcripts of observation field notes and interviews were transcribed verbatim and analyzed. Intimacy and experiences with ATS determined the MSM's continuously used ATS. However, perceived discrimination from health care professionals and lack of guidance to stop using ATS were the major barriers of engagement in substance use care. Since almost participants concerned about anti-HIV medication treatment, they adopted culturally behaviors to maintain their health. Findings from this study provided research, practice and policy guidance for how to prevent ATS use and provide appropriate HIV care for HIV-infected MSM.

並列關鍵字

amphetamine use ； HIV care ； men who have sex with men ； focused ethnography