台灣北部地區色情三溫暖之女性性工作者對愛滋病的知識、態度及相關行為之研究

A Survey of Knowledge, Attitudes and Practices Concerning Aids among Female Sex Workers from Massage Parlors in Taiwan

10.6288/CJPH1997-16-01-04

陳宜民(Yi-Ming A. Chen)；張麗雅(Li-Ya Chang)；任一安(Ian Jen)；傅瓊瑤(Chong-Yau Fu)；周碧瑟(Pesus Chou)

後天免疫缺乏症候群 ； 人類免疫不全病毒 ； 知識態度行為研究 ； 女性性工作者 ； Acquired Immunodeficiency Syndrome AIDS ； Human Immunodeficiency Virus ； KAP Study ； Female Sex Worker

中華公共衛生雜誌

16卷1期（1997 / 02 / 01）

37 - 51

繁體中文

性工作者是感染人類免疫不全病毒（簡稱愛滋病病毒）的高危險群之一。而其中無執照的非法女性性工作者常成為愛滋病防治上的死角。本研究乃針對在台北市、台北縣及桃園縣五家色情三溫暖工作的139位女性性工作者，調查其感染愛滋病病毒第一型、第二型與梅毒的情形，以及其對愛滋病的知識、態度與相關行為。結果發現研究對象無人感染愛滋病病毒，但有四人(2.9%)血清梅毒抗體呈陽性反應。在人口學特性方面，40%的研究對象年齡介於30~34歲之問；65%的教育程度在高職以上；29%已婚；23%離婚。 整體而言，女性性工作者對愛滋病的傳染途徑較為瞭解，對不會傳染愛滋病的知識則較為缺乏。在對愛滋病的態度三成份方面，認知態度較偏正向；情感方面，害怕感染愛滋病的態度則視不同情況而有所差異；行為意向方面，則屬中間偏正向的態度。態度三成份之間以情感與意向的相關最強，認知與意向的相關最弱。在愛滋病的相關行為方面，研究對象平均每月工作22天，74%平均一天接客4~6人，60%曾接過外國顧客。此外，只有42%女性性工作者會要求其男友或先生完全使用保險套，顯著低於其與一般顧客之完全使用保險套的比率(94%)。值得注意的是，32%與其男友或先生性交時從未使用過保險套。有25%曾經使用過鎮靜劑、安眠藥或靜脈注射麻醉藥品；76%曾接受過愛滋病毒血液抗體檢查。 在愛滋病的知識、態度及行為三者的相關性方面，愛滋病的知識與整體態度呈正向的關係，尤其是不會傳染愛滋病途徑的知識得分與對愛滋病在認知方面的態度呈有意義的相關。但研究對象的知識得分與其性對象的保險套使用率則呈負相關，尤其是與男友或先生性交的保險套使用情形與知識得分的負相關最佳。不過值得重視的是，在態度上害怕與先生或男友不戴保險套性交會感染愛滋病者，其與先生或男友保險套使用率較高；同時，對愛滋病認知危險性得分高者其主動接受愛滋病血液檢驗的比率亦較高；顯示要改變研究對象的行為，採用改變其態度的技巧可能較增加其愛滋病的知識更為有效。在影響研究對象對愛滋病之知識、態度與行為的因素方面，年齡與愛滋病知識得分有顯著正相關；但年齡愈大與先生或男友的保險套使用率愈低。教育程度為大專者，以及婚姻狀況為已婚者，與接受愛滋病血液篩檢有顯著相關。以上結果，可提供未來針對女性性工作者設計預防愛滋策略之參考。

Commercial sex workers (CSWs) are at high risk for human immunodeficiency virus (HIV) infection. Because of their illegal status, unlicensed female CSWs deserve special attention with regards to AIDS education and prevention. In this study, 139 CSWs from 5 massage parlors in Taipei City, Taipei prefecture and Taoyuan prefecture were tested for HIV-1, -2 and syphilis infections and surveyed on their knowledge, attitudes and practices (KAP) concerning AIDS. The results showed that none of them had HIV-1/2 infection, while 4 (2.9%) had syphilis. Forty% of them were between 30 and 34 years old; 65% of them had senior high-school and above level of education; 23% were divorced; 29% were married. Although they demonstrated a good understanding of the routes of HIV-1 infection, many still had misconceptions about the infection. In terms of their attitudes toward AIDS, cognition tended to be positive, affection was dependent on the specific situation and conation was neutral to positive. The affection and conation elements of their attitudes had the strongest association and the association of cognition and conation was the weakest. In average, the CSWs worked 22 days per month. Seventy-four% of them had 4-6 clients per day, and 60% of them had foreign clients. In addition, only 42% of the CSWs consistently asked their boyfriends or husbands to wear condoms when they had sex intercourse, which was significantly lower than the rate of condom usage among their customers (94%). Thirty-two% of CSWs reported that their boyfriends or husbands have never used condoms previously. Twenty-five% of the CSWs have taken sedatives and narcotics. Seventy-six% of the CSWs had previously undergone the HIV-l blood test. In this study, there is a positive correlation between knowledge and attitudes toward ADS, especially the association between the knowledge of the ways in which HIV is not transmitted and the cognition element of the attitudes. There is a negative correlation between knowledge and the condom usage rates among those CSW's boyfriends and husbands. Nevertheless, condom usage frequencies by boyfriends and husbands were much higher among those CSWs who stated that they were concerned about contracting HIV-1 infection from their boyfriends or husbands if they did not use condoms. In addition, those CSWs who had scored higher on risk cognition had higher rate of seeking blood test for FIIV-1 infection. Finally, factors which related to the KAP of CSWs, including age, marital status and education level were analyzed. This study may provide valuable information for designing ADS education materials for female CSWs in Taiwan.