接受愛滋病個案管理之男同志保險套使用行為意圖及相關因素探討

The intention of condom use behavior and related factors among gay male whom accept HIV/ AIDS case management

陳立樺(Li-Hua Chen)

指導教授 ： 邱啟潤

高雄醫學大學/護理學院/護理學系研究所/碩士(2013年)

摘要

背景：台灣推動「愛滋病個案管理計畫」，希望藉此降低已感染者危險性行為，但每年新感染人數仍有約2,200人，所以了解愛滋病毒感染者保險套使用行為意圖及相關因素，是目前愛滋病防治的重要議題。
目的：應用計畫行為理論模式來探討接受愛滋病個案管理男同志之保險套使用行為意圖及重要解釋因子。
方法：以立意取樣，在南部某醫學中心，選取加入「愛滋病個案管理計畫」並連續追蹤管理2次，且有規律回診者。採結構式問卷包括基本資料、態度、主觀規範、知覺行為控制及保險套行為意圖量表。其信效度Cronbach’sα值介於.70至.94之間；專家內容效度之CVI值為.84至 .98間，共回收203份。
結果：（1）未來半年面對固定與非固定性伴侶口交與肛交性行為，每次都會使用保險套的行為意圖為18.2%、54.7%；27.1%、60.1%。（2）固定與非固定性伴侶過去性行為時未曾喝酒或使用藥物者，口交時保險套使用行為意圖較高。（3）固定與非固定性伴侶口交保險套使用行為意圖之重要解釋因子為知覺行為控制。（4）固定與非固定性伴侶肛交保險套使用行為意圖之重要解釋因子為主觀規範。
結論:接受愛滋病個案管理之男同志，未來半年性行為時每次都使用保險套行為意圖偏低，研究結果顯示「主觀規範」與「知覺行為控制｣因素為主要解釋因子，建議衛生單位可將其列為政策規劃參考，發展出更有效的愛滋病毒感染防治政策，並針對健康狀況提升之個案應持續強化安全性行為衛教，進而降低感染者二次傳播的機率。

關鍵字

愛滋病個案管理 ； 男同志 ； 保險套使用行為意圖 ； 計畫行為理論

並列摘要

Background: The “HIV/AIDS Case Management Program” was promoted in Taiwan in order to reduce infected individuals’ dangerous behaviors. However, there are still approximately 2,200 newly infected cases every year, therefore, understanding the intention of condom use behavior and related factors is critical for AIDS prevention at the present.
Objective: To apply the planned behavior theory model of the program to investigate the intention of condom use behaviors and important related factors of the gay male whom accept HIV/AIDS case management.
Method: The study used purposive sampling to select cases from the “HIV/AIDS Case Management Program” in a medical center in southern Taiwan. Cases must have regular follow-ups and be tracked twice. The study used structural questionnaire which included basic information, attitude, subjective norm, and perceived behavioral control toward condom use, and scale on the intention of condom use behaviors. Reliability and validity analysis of the questionnaire indicated a Cranach’s α value of 0.70 to 0.94, and expert validity revealed CVI of 0.84 to 0.98. The study collected a total of 203 questionnaires.
Result: (1) The intention for condom use was 18.2% and 54.7% for oral and vaginal intercourses, respective with main sexual partners in the next six months; and 27.1% and 60.1% with nonmain sexual partners. (2) Higher intention for condom use during oral intercourse was observed when cases did not drink alcohol or use drug. (3) Perceived behavioral control was an important explanatory factor for the intention of condom use during oral intercourse for both main and nonmain sexual partners. (4) Subjective norm was an important explanatory factor for the intention of condom use during vaginal intercourse for both main and nonmain sexual partners.
Conclusion: The intention for condom use behavior every time during intercourse was low among homosexual males who were in the “HIV/AIDS Case Management Program.” The study indicated that subjective norm and perceived behavioral control were the main explanatory factors. Result of the study can be a reference for future policy and HIV/AIDS prevention programs. Continuing health education on safe sexual behavior can help improve the health condition of the infected cases and reduced the chances of secondary transmission.

並列關鍵字

HIV/AIDS Case Management Program ； homosexual male ； intention of condom use behaviors ； planned behavior theory.

參考文獻

Molla, M., Astrom, A. N., & Berhane, Y. (2007). Applicability of the theory of planned behavior to intended and self-reported condom use in a rural Ethiopian population. AIDS Care, 19(3), 425-431. doi: 10.1080/09540120600722692

行政院衛生署疾病管制局（2012）．101年12月HIV/AIDS統計月報表．取自http://www.cdc.gov.tw/professional/Data/59359AFFA04851.Pdf。

行政院衛生署疾病管制局（2013）．102年4月HIV/AIDS統計月報表．取自http://www.cdc.gov.tw/professional/Data/58114AFB86117F53.Pdf。

行政院衛生署疾病管制局（2011）．102年愛滋防治替代治療委託計畫．取自http://www2.cdc.gov.tw/content.asp32368。

行政院衛生署疾病管制局（2012）．愛滋病個案管理計畫書．取自http://www.cdc.gov.tw/professional/info.asp28A7DBC51B5BF60C。