AIDS Knowledge among Arrested Drug Users in Taoyuan During the First Two Years of Implementation of a Harm Reduction Program

背景：2004年，台灣愛滋疫情在靜脈藥癮者爆發，原因是靜脈藥癮者共用針具、洗滌水及稀釋液。2006年7月起全國實施減害計畫。桃園縣政府衛生局自2006年7月起對縣內被警方查獲的藥癮者，進行愛滋知識測驗卷調查，以瞭解藥癮者的愛滋知識程度。在填寫測驗卷後，提供愛滋預防衛教單張及減害計畫的訊息，希望對被警方查獲的藥癮者本人及藉由藥癮族群間的網絡，提供正確的愛滋預防知識及減害計畫的訊息。 目的：調查桃園地區實施減害計畫第一、二年的警方查獲藥癮者之愛滋知識，評估衛教單張對於提升藥癮者的愛滋知識的成效。 方法：依時間列出愛滋知識的答對率(%)、95%信賴區間，及比較不同時間查獲相同藥癮者的愛滋知識。 結果：2006年7月至2008年2月有效樣本數共1828份，藥癮者愛滋知識平均答對比例為52.1% (95%信賴區間=51.4%-52.8%)。愛滋知識答對率在實施減害計畫的首兩年期間變化不大。絕大部份藥癮者(95%)能答對洗筆水、稀釋液可傳播愛滋病毒，又此題的答對率在研究期間變化不大。對於被警方重覆查獲的藥癮者(n=153)，其第二次被警方查獲的愛滋知識分數卻顯著低於第一次的分數(P < .0001)。 結論：本研究結果顯示減害計畫的首二年絕大部份藥癮者都知道洗筆水、稀釋液可傳播愛滋病毒，顯示減害計畫在宣導安全注射藥物訊息的成效。對警方查獲藥癮者，只給予愛滋預防衛教單張是不足夠，可嘗試不同衛教方法。
Background: In 2004, Taiwan experienced a dramatic increase in number of intravenous drug users (IDUs) in the HIV/AIDS epidemic because IDUs shared syringes, needles, washing water, and diluted liquid. After July 2006, Taiwan implemented a nationwide harm reduction program (HRP). The Public Health Bureau of the Taoyuan county has also started to administer a quiz to arrested drug addicts to assess their knowledge about AIDS prevention. After filling out the quiz, the addicts were given leaflets about AIDS prevention and the HRP in the hope that accurate information about AIDS prevention and the HRP could be shared among drug users and their networks. Aims: This study aimed to investigate AIDS prevention knowledge among drug users arrested by police in Taoyuan during the first two years of implementation of a HRP and to evaluate the effect of giving out the AIDS leaflets. Methods: Mean and 95% confidence interval (CI) of the rate of correct answers by time were calculated to assess their AIDS prevention knowledge. Comparison of AIDS prevention knowledge among repeatedly arrested drug users were also made. Results: Between July 2006 and February 2008, 1,828 arrested drug users filled out the AIDS knowledge quiz, and the mean proportion of correct answers was 52.1% (95% CI=51.4%-52.8%). This proportion of correct answers remained the same over the two-year period. Most respondents (95.0%) answered the questions about pen-washing water and diluted liquid can transmit HIV correctly, and this correct answer rate remained stable throughout the study period. The repeat-arrested drug users (n=153) were found to have worse AIDS knowledge at the second arrest than at the first arrest (P < .0001). Conclusion: The results indicate that during the first two years of the HRP, most respondents already knew that washing water and diluted liquid can transmit HIV, indicating the HRP had successfully promoted safer drug injections. However, for arrested drug users, simply giving out a leaflet about AIDS prevention is insufficient and different education methods is worth trying.