台灣男男性行為者對愛滋病毒暴露前預防性用藥看法、使用動機與經驗之探討

The Opinions, Motivators, and Experiences of HIV Pre-exposure Prophylaxis Usage among Men Who Have Sex with Men in Taiwan

曾巽貽(Tseng Hsun-Yi)

指導教授 ： 張鳳琴

國立臺灣師範大學/教育學院/健康促進與衛生教育學系/碩士(2020年)

https://doi.org/10.6345/NTNU202000195

摘要

本研究目的瞭解男男性行為者對愛滋病毒暴露前預防性用藥（Pre-exposure prophylaxis，簡稱PrEP）的看法、使用動機及經驗。本研究方法為質性研究，以立意取樣的方式邀請七位男男性行為者進行訪談， 研究結果如下：
一、 高風險性行為：男男性行為者在東方文化影響下，擔心不被爸媽或社會大眾認同，而採地下化交友模式，以約炮方式在沒有使用保險套或對性行為對象不瞭解的情況之下進行高風險性行為，因而增加感染愛滋病毒的機率。
二、 對愛滋病的預防措施：男男性行為者因對愛滋病感到恐懼而採取預防措施，認為健康必須由自己來守護，大多會使用保險套及定期篩檢方式，而在從事危險性行為之後則會使用愛滋病毒暴露後預防性用藥（Post-exposure prophylaxis，簡稱PEP）。
三、 對PrEP看法與使用動機：男男性行為者對PrEP的資訊來源主要來自於網路媒體的介紹、親友或醫療人員推薦，而得知預防愛滋效果可達90%以上、副作用低且能多一層保護，另使用PrEP的動機為曾有危險性行為經驗及公費補助。
四、 PrEP的使用經驗：男男性行為者表示使用 PrEP的優點包括可定期回診追蹤健康情形，且能較安心的進行無套性行為；缺點包括因無套性行為而增加感染其他性病的風險，或被冠上性濫交、愛滋感染者等汙名，且自費價格較高、就醫不便又可能漏吃藥。儘管有這些風險及困境，然受訪者多認為PrEP是很好的預防愛滋感染措施。
本研究建議增加開立PrEP醫療院所的可近性，讓就醫便利性增加，以及降低自費PrEP的費用，進而讓男男性行為高危險群更願意使用PrEP，社會大眾能對同性戀及愛滋病更加友善，以減少歧視與標籤化，俾利於愛滋病預防教育的推廣，進而減少新增愛滋感染者，以達到終止愛滋病願景。

關鍵字

男男性行為者 ； 愛滋病毒暴露前預防性用藥 ； 動機 ； 經驗

並列摘要

The purpose of this study was to explore opinions, motivators and using experiences of pre-exposure prophylaxis (PrEP) among men who have sex with men (MSM). This study used qualitative interview method. Seven MSM were invited to conduct interviews. The interviews were converted into verbatim transcripts for analysis.
The results found that MSM participants tended to engage in underground dating and risky sexual behaviors because of cultural influences and social identification, while they took protective measures such as condom use and regular HIV screening due to the fear of AIDS. Participants reported heard about PrEP through online sources, relatives, friends, and health professionals, while they believed that PrEP had high effects on preventing HIV infection and low side effects. Participants reported that the reasons for wanting to try PrEP were risk sexual behaviors and governmental subsidy, while they also reported the advantages of using PrEP including receiving regular screening and less worried of risky sexual behaviors. However, the disadvantages of using PrEP included more vulnerable to other sexually transmitted infections and being tagged as sexual promiscuity or HIV positive. Participants also reported the barriers to PrEP use including high price, inconvenience to obtain PrEP, and difficulty taking pills. Overall, participants thought the advantages of PrEP outweighed the disadvantages.
It was suggested that government should increase the availability of PrEP, reduces cost, and enhance behavioral efficacy to use PrEP, while the public could be more friendly toward homosexuality and AIDS to reduce discrimination, strengthen HIV prevention, and achieve the vision of ending AIDS.

並列關鍵字

MSM ； pre-exposure prophylaxis ； Motivators ； Experience

參考文獻

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