台灣感染愛滋受刑人的生活品質探討

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Title:	台灣感染愛滋受刑人的生活品質探討 HIV-infected inmates reported quality of life in Taiwan
Authors:	林伯昌
Contributors:	公共衛生學系碩士班
Keywords:	愛滋病;生活品質;受刑人 HIV/AIDS, quality of life, inmates
Date:	2011-07-29
Issue Date:	2011-10-17 16:16:37 (UTC+8)
Publisher:	中國醫藥大學
Abstract:	背景：愛滋病因為雞尾酒療法的應用，使得疾病趨於慢性化、存活期延長，愛滋感染的盛行率也持續增加。靜脈藥癮者是台灣愛滋病感染的主要危險次族群之一，此族群常因毒品的持有或使用，造成犯罪而判刑入獄，以致矯正機關內的愛滋病感染者近年來增加，且大部份是靜脈藥癮者，帶來醫療照護與管理的問題。健康生活品質的測量可以提供臨床照顧的評估參考。本研究主要是探討於矯正機關內的愛滋病感染受刑人的健康生活品質，並分析其影響因素。方法：本研究為一橫斷面研究。使用世界衛生組織的生活品質問卷測量矯正機關內的愛滋受刑人，包含生理健康、心理健康、社會關係與環境等四個層面。並以複迴歸分析探討生活品質影響因子。結果：總共 261 位被納入研究，66 位是女性，195 位是男性(74.7%)。大部份測試者是單身(59.8%)。超過一半(62.9%)的受刑人感染愛滋病少於四年，14.3%符合AIDS的定義，13.4%正在接受雞尾酒藥物治療。複迴歸分析結果顯示男性、非獨居與高的免疫細胞球者有較佳的生理健康。非獨居、有性生活、主要經濟來源是正常工作及每天花費藥錢超過新台幣2000元的感染受刑人有較佳的心理的健康。年紀輕、主要經濟來源是工作且越早接觸藥品者有較佳的社會關係。使用毒品經驗越久的男性則有較佳的環境層面的生活品質。結論：本研究提供感染愛滋病受刑人族群的健康生活品質探討與影響因素，可作為促進病人照顧與相關政策的參考。 Objective: HIV infection reates are increasing in Taiwan and the introduction of highly active antiretroviral therapy there is now hope for long-term management of the disease. Intravenous drug users who are HIV-positive are an important subgroup in Taiwan. The punishment for illegal drug use is usually a jail sentence, and as a result, there is a high prevalence rate of HIV/AIDS in Taiwan’s prisons. Health-related quality of life (HRQoL) is an important medical outcome and because HIV/AIDS inmates will eventually return to society, from a public health perspective, it is important to gain a better understanding of this population. The aim of this study was to investigate the health-related quality of life among HIV-positive inmates and to determine which factors affect HRQoL. Methods & Methods: We conducted a cross-sectional prospective analysis of an HIV clinic based cohort in a correctional facility. HRQoL was assessed using the WHOQOL-BREF (Taiwan version), which includes four domains of: physical, psychological, social relationships and environment. Factors associated with HRQoL were determined by linear regression models. Results: The participants consisted of 66 females and 195 male HIV seropositive prisoners. Male accounted for 74.7%, and 59.8% of subjects were single. More than half (62.9%) had been diagnosed with HIV infection for less than four years, only 14.3 % of them had full-blown AIDS, and 13.4 % received combination antiretroviral treatment. Male gender, not living alone, and higher CD4 counts were correlated with significantly better physical health. Not living alone, having sexual activity, income source mainly from work, and higher daily drug cost (more than NT$2000) before incarceration were associated with significantly better psychological health. Younger age, income source mainly from work, and exposure to illicit drugs earlier were correlated with significantly better quality of life in the social domain. Males with longer illicit drug use history had significantly better quality of life in the environmental domain. Conclusions: The factors affecting HRQoL of HIV/AIDS inmates found in this study may be of value to researchers, healthcare providers, health policymakers and correctional facility managers in order to promote health care, develop intervention strategies, and establish education programs.
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