| Summary: | 碩士 === 國立東華大學 === 公共行政研究所 === 99 === This study aims at investigating the HIV infection rate due to the unsafe injection and sexual risk behavior among injecting drug users; examining the gap between the outcome of current harm reduction program and the result of actual observation; analyzing if injection of addictive drugs is closely related to HIV infection rate; exploring if there are large gaps in the classification of HIV and intravenous drug use; investigating the incentives to improving the participation in harm reduction program, exploring drug users in a community and strengthening the effectiveness of AIDS prevention; providing guidance for the drug users out of jail to continue to accept the treatment provided by the agency of replacement therapy to prevent HIV transmission because their whereabouts are unknown after coming out of jail; analyzing the information obtained and providing specific policies or recommendations with respect to the current harm reduction program.
The approach adopted in this study is in-depth interview of qualitative research and semi-structured interview outline. 14 interviewees were selected as the objects of this study, including 4 drug users in jail and 10 drug users in community. These interviewees were limited to the intravenous injection drug users who had participated in a harm reduction program but not necessarily to the AIDS patients caused by drug use. The content of interview includes personal basic information, habit of drug use, health consciousness and action, needle and syringe cleaning program, replacement therapy program, and relevant suggestions. According to the result of the study, we find that drug users’ participation motivation for harm reduction program would make a huge impact on the promotion of harm reduction program and drug users’ habit of drug use is closely related to AIDS epidemic situation. As to the feasibility of introduction of replacement therapy for drug users before going out of jail still needs further assessment.
To sum up, with respect to the promotion of needle and syringe cleaning program, the countermeasures include reducing police investigation and taking into consideration the actual needs of the drug users in order to make some chain convenient stores and gas stations as the locations for needle and syringe cleaning. As to the promotion of replacement therapy program, the countermeasures include reducing police investigation and also making some Health Centers and good pharmacies as the new locations for providing Methadone in order to improve the convenience for the drug users to accept the replacement therapy. As for the timing of intervention of health education or counseling, it is suggested that it would be much better to conduct the intervention earlier. It shall be implemented through the health education programs in the last two years of primary school. Besides, the study considers that the integration of resources is helpful for the promotion of harm reduction program. The implementation of cooperation of public and private sectors, strengthening of integration of resources, and development of more effective harm reduction policy will be the important key to the achievement of the ultimate goal of harm reduction program. Meanwhile, the study considers that the competent authority shall attach much importance to the evaluation of the policy of harm reduction program and should not consider the epidemic situation data as the sole reference for the policy evaluation. And, the competent authority shall not conduct the policy evaluation by means of commissioning plan and neglect the difficulties generated in the process of promotion of harm reduction program. Finally, this study suggests that the competent authority shall try to understand the subsidiary units’ implementation situation of the promotion of harm reduction program and the difficulties they encountered in such process, investigate drug users’ actual needs, invite scholars and experts, relevant government departments and non-governmental caring organization to study the policy regularly, take up the evaluation of policy in all respects, analyze the needs of harm reduction program and enhance the policy functions to make our country’s harm reduction program more effective and complete.
Prevention is better than cure. This study suggests that we shall enhance AIDS prevention advocacy in school and AIDS prevention education in jail and promote the health education in respect of peer education of drug users to make harm reduction program to produce a marked effect. And, we shall take advantage of the mass media and print media such as the Internet, TV and newspapers, electronics news to take up policy advocacy and information providing in order to make the policy marketing channel unimpeded; we shall enhance drug addiction counseling for drug users to help them to get rid of psychological shadow and participate in the harm reduction program; we shall cooperate with employment services to improve job matching for the drug users after leaving jail and help them to resume a normal life; we shall remove obstacles to participating in harm reduction program, provide safe environment for harm reduction and improve the effectiveness of harm reduction; we shall take into full consideration the harm reduction suggestions offered by the drug users, examine the feasibility of those suggestions and meet drug users’ actual needs; we shall enhance the government’s horizontal link function of, integrate governmental and non-governmental forces and optimize limited resources.
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