| Summary: | 碩士 === 國立臺灣大學 === 衛生政策與管理研究所 === 94 === In the past two decades, because of a consistently exceptionally low HIV seropositive rate, the injection drug users (IDUs) constitutes the least noticed “high risk” group in Taiwan’s HIV/AIDS prevention and control. The stable low prevalence has been changed since the beginning of the 21st century particularly while 565 HIV seropositves were reported in 2004 and the number abruptly increased to 2055 in 2005. The purpose of this study is thus to explore factors that might contribute to the outbreak of HIV infection among IDU population in Taiwan, and provide suggestions for current and future HIV/AIDS prevention and control policy and programs targeted on the IDUs group.
This research was conducted from February to December 2005. Qualitative data were collected through both in-depth interviewing and focus group interview in a correctional organization located in the northwest part of Taiwan. The major findings of the study include four parts. First, from IDUs’ point of view, their style of living was delineated, the attraction of the substance was emphasized, the networking and relationships among peer IDUs was outlined, and the rise and fall of their life course was depicted. Second, the pattern of drug use was articulated. Particularly highlighted were the difference between inhaling and injecting, and the context in which the injection of the addictive substance was carried on. Third, the impact of macro-level forces on the IDUs and their drug use pattern. The most significant points were the change of drug control policy, the implementation of harm reduction programs, the attack of disaster such as SARS, the transnational drift of population and drugs, and the contact with another high risk group such as MSM (men who have sex with men). Finally, situations which pose IDUs under the threat of HIV infection were indicated, including solvent sharing, syringe and needle sharing, deficiency and misconceptions in HIV/AIDS knowledge, and unsafe sex behaviors. The characteristic subculture of drug using and the intricate networks of IDU members constitute the most challenging barriers to HIV/AIDS control. In summary, the HIV infection in the past few years among the IDUs has dramatically turned out to be an outbreak is due mainly to collective transmission, i.e., the spread of HIV was achieved through contagion between “groups,” not individuals.
Two suggestions are proposed on the findings of the study. First, we should enhance the IDUs’ knowledge and skills in HIV/AIDS prevention, and the most efficient strategy is to utilize their unique networking interaction, starting from the IDU members in the correctional organizations, to develop a special type of peer training and education. Moreover, issues related to other infectious diseases such as hepatitis B and C should also be incorporated into the educational efforts. Secondly, barriers for IDUs to participate in harm reduction programs should be identified and eliminated.
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