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標題: | 台灣男性性少數使用愛滋病預防性投藥之服務的阻礙與促進因素 Barriers and Facilitators to Engagement in Pre-Exposure Prophylaxis Services for Sexual Minority Men in Taiwan |
作者: | 麥晨晧 Daniel Frank Mayo |
指導教授: | 黃柏堯 Poyao Huang |
關鍵字: | 預防性預防藥物,愛滋病預防,性少數男性,醫療保健利用, Pre-Exposure Prophylaxis,HIV Prevention,Sexual Minority Men,Healthcare Utilization, |
出版年 : | 2023 |
學位: | 碩士 |
摘要: | 背景:過去十年,愛滋病預防性暴露前預防性投藥(PrEP)在性少數男性(SMM)中已成為HIV預防的關鍵策略。然而,SMM仍面臨PrEP接受和利用的障礙。本研究回顧了在臺灣和全球範疇中影響SMM群體PrEP利用的相關因素。目的:本研究考慮了在臺灣SMM中PrEP利用的誘發、促成和需求因素,並討論這些因素與PrEP照護流程之間的關係。方法:我們進行了線上橫斷調查,檢視了與PrEP利用相關的各種誘發、促成和需求因素。研究招募了249名年齡在18歲及以上(平均年齡32.81歲;標準差8.75歲)的臺灣SMM參與、他們自認為是男性、且HIV測試結果為陰性、目前居住在臺灣。我們使用描述性統計、單變量線性回歸和階層線性回歸等方法來分析數據,深入瞭解參與者特徵,並研究這些特徵與臺灣SMM中PrEP照護流程得分之間的關聯。結果:研究顯示多個因素與PrEP照護流程得分之間存在顯著關聯,其中包括關係狀態、身份認同確認、內在恐同、HIV或性傳染感染(STI)檢測、以及其他與性行為和健康相關的變數。此外,PrEP效力知識、獲取PrEP處方的正式途徑、以及特定網路行為也與PrEP照護流程得分呈現相關。階層線性回歸分析顯示,誘發和促成因素的綜合效應解釋了PrEP照護流程得分變異的相當大部分(41%)(F(17, 210) = 10.82,p < .001)。然而,將需求因素納入回歸模型對PrEP照護流程得分的預測並未產生顯著貢獻(p > .05)。結論:研究結果顯示,關係狀態、HIV和STI檢測、PrEP相關知識和交友軟體使用是影響臺灣SMM中PrEP利用的重要因素。這些發現對於臺灣的醫療保健提供者和政策制定者具有實際意義,建議他們進一步發展針對性的干預措施,以改善SMM對PrEP的接受情況。此外,本研究複製了先前確認的因素,並闡明了PrEP相關被忽視的因素,顯著增進了對全球SMM群體PrEP利用的理解,凸顯了實施有效HIV預防策略所需全面因素的重要性。 Background: In the past decade, the use of pre-exposure prophylaxis (PrEP) has emerged as a crucial strategy in HIV prevention among sexual minority men (SMM). However, barriers continue to hinder PrEP uptake among SMM. This study reviews the factors related to PrEP utilization among SMM in Taiwan and globally. Objective: This study considers the predisposing, enabling, and need factors associated with PrEP utilization among SMM in Taiwan, discussing their relationship with the PrEP care continuum. Methods: An online cross-sectional survey was conducted to examine a range of predisposing, enabling, and need factors related to PrEP utilization among eligible SMM. A convenience sample of 249 participants, aged 18 and older (M = 32.81 years; SD = 8.75), identifying as cisgender SMM with a negative HIV status, residing in Taiwan, was recruited for the study. Descriptive statistics, univariate linear regressions, and hierarchical linear regression were employed to analyze the data, providing insights into participants’ characteristics and examining the associations between predisposing, enabling, and need factors and the PrEP care continuum score among eligible SMM in Taiwan. Results: The study revealed significant associations between various factors and the PrEP care continuum score. These factors encompassed relationship status, identity affirmation, internalized homophobia, HIV or sexually transmitted infection (STI) testing, and other variables related to sexual behavior and health. Additionally, knowledge of PrEP efficacy, access to formal sources for obtaining a PrEP prescription, and engagement in certain online behaviors also correlated with the PrEP care continuum score. The hierarchical linear regression analysis revealed that the combined effect of predisposing and enabling factors accounted for a substantial proportion (41%) of the variability in the PrEP care continuum score (F(17, 210) = 10.82, p < .001). However, the inclusion of need factors in the regression model did not significantly contribute to the prediction of the PrEP care continuum score (p > .05). Conclusions: Together, the findings suggest that relationship status, HIV and STI testing, PrEP-related knowledge, and dating app use were important factors related to PrEP utilization. These findings have practical implications for Taiwanese healthcare providers and policymakers, who can further develop targeted interventions to improve PrEP uptake among SMM. Furthermore, this study significantly enhances the global understanding of PrEP utilization among SMM populations. It achieves this by replicating previously identified factors and shedding light on previously overlooked factors related to PrEP, underscoring the critical importance of addressing a comprehensive range of factors for the implementation of effective HIV prevention strategies. |
URI: | http://tdr.lib.ntu.edu.tw/jspui/handle/123456789/89826 |
DOI: | 10.6342/NTU202303766 |
全文授權: | 同意授權(全球公開) |
顯示於系所單位: | 全球衛生學位學程 |
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