本研究以PRECEDE模式(Green,1991)為主要理論基礎來探討及預測女性藥癮患者的愛滋病篩檢行為。研究樣本為台灣北、中、南部三所煙毒戒治所的1185名女性藥癮患者,研究工具為結構式自填問卷,內容包括對過去的愛滋病危險行為、過去主動篩檢情形、未來主動篩檢意願等項目的調查,以及PRECEDE模式中的傾向因素(愛滋病知識、愛滋病易感性、愛滋病嚴重度、愛滋病篩檢效用、愛滋病篩檢障礙)、促成因素(對篩檢資源的了解程度)、增強因素(同儕因素、配偶或性伴侶因素)三大項目的測量。以描述性統計、單因子變異數分析、卡方檢定、相關分析、複迴歸等進行資料分析。 研究結果發現樣本中僅有92位曾主動接受愛滋病篩檢,主動篩檢率為8%;在愛滋病危險行為方面,樣本中有32.2%曾與他人共用針頭、13.3%曾因藥物或金錢而性交易、29.2%在過去一年中有多重性伴侶、59.7%在過去一年性行為中無保險套使用習慣。過去曾主動篩檢者的用藥種類、對此次戒治是否接受篩檢的認知、年齡、受教育年數等基本資料變項皆與未曾主動篩檢者有顯著差異,認知的愛滋病篩檢效用、對篩檢資源的了解程度、同儕因素、配偶或性伴侶因素顯著高於未曾主動篩檢者,未來主動篩檢意願亦明顯較高,認知的愛滋病篩檢障礙則顯著較低。另外,PRECEDE模式中的愛滋病易感性、愛滋病篩檢效用、愛滋病篩檢障礙、配偶或性伴侶因素未來主動篩檢意願的顯著預測因子,可解釋未來主動篩檢意願16.6%的變異量;PRECEDE模式中的愛滋病知識、愛滋病嚴重度、對篩檢資源的了解程度、同儕因素則非未來主動篩檢意願的顯著預測因子。 根據研究結果,作者認為女性藥癮患者的愛滋病防治策略可透過改變其愛滋病易感性、愛滋病篩檢效用、愛滋病篩檢障礙、配偶或性伴侶因素等方面來提高其未來主動篩檢意願,以促使其主動尋求篩檢,增加此愛滋病高危險群的主動篩檢率。換句話說,針對女性藥癮患者,衛生教育應加強其對愛滋病危險行為之認知,使其了解何種行為容易感染愛滋病;同時應極力宣導愛滋病篩檢的好處,提高女性藥癮患者對愛滋病篩檢效用的認同;而且應採取有效管道進行愛滋病衛生教育,以利相關訊息在藥癮族群間的傳播,使女性藥癮患者及其配偶或性伴侶都能對愛滋病有基本的認識;在推廣愛滋病防治時,亦應注意勿造成社會大眾對愛滋病的刻板印象,以免無意間形成愛滋病篩檢的障礙。
Method: This study intended to use the PRECEDE model to examine the voluntary HIV testing behaviors of female drug abusers. There were 1185 participants recruited in this study. Data regarding participants’ background, HIV risk behaviors, voluntary HIV testing experience , and factors of the PRECEDE model were collected. Univariate analysis and multiple regression were performed. Result: Only 92 (8%) of the participants self-reported that they had taken voluntary HIV testing in their lifetime. 32.2% of the participants had ever engaged in needle sharing with other intravenous drug users, 13.3% had ever traded sex for drug or money, 29.2% had multiple sex partners and 59.7% hadn’t condom using habit during sex in the past one year. Perceived benefits of taking HIV testing, understanding about information of HIV testing, peer factor, spouse (sexual partner) factor, and the intention to take voluntary HIV testing of participants who had ever taken voluntary HIV testing were significant higher than who hadn’t, but perceived barriers of taking HIV testing of participants was significant lower. Besides this, perceived susceptibility of HIV infection, perceived benefit and barrier of taking HIV testing, and spouse (sexual partner) factor were significant predictors of the voluntary HIV testing will, but perceived severity of AIDS, understanding about information of HIV testing, and peer factor weren’t. The PRECEDE model can explain 16.6% variances of the intention to take voluntary HIV testing. Conclusions: According to the result, the author suggested that effective HIV protective strategies for female drug abusers should be toward increasing their recognition of HIV risk behaviors, promoting the benefit of HIV testing, and accelerating the protective information spread among this population.