臺灣博碩士論文加值系統

背景：男性間性行為（men who has sex with men, MSM）是台灣愛滋病毒感染主要族群，聊天室為男同志網路性邀約常見管道，網路性邀約愛滋感染風險高。
研究目的：觀察網路聊天室公開交友資訊，分析男同志網路交友用語與愛滋病毒感染危險行為之關聯性。
研究方法:使用電腦程式進行資料採礦，收集18歲以上男同志聊天室公開交友資訊，共納入610,058筆資料，以專家意見定義愛滋感染危險行為關鍵字，運用SPSS統計軟體及關聯性法則分析，預測男同志交友用語與愛滋感染行為之相關性。
結果:男同志網路聊天室中邀約性行為之比率為17.2%，邀約娛樂性藥物為10.6%，邀約無套性行為為1.0%，自述為愛滋感染者0.9%。邀約娛樂性藥物(aOR= 4.16, 95% CI:3.93, 4.39)及自述愛滋病毒感染(aOR=1.94, 95% CI:1.64, 2.26)為預測無套性行為之主要關鍵因素。邀約娛樂性藥物風險的預測因素為邀約無套性行為(aOR=4.16, 95% CI:3.93, 4.39)及自述愛滋感染者(aOR=7.60, 95% CI:7.20, 8.03)。邀約使用娛樂性藥物及邀約無套性行為者其自述為愛滋感染者的機會高達50.5%，關聯性法則運算邀約無套性行為當中最常使用的關鍵為使用娛樂性藥物及性器官描述。
結論：邀約使用娛樂性藥物及邀約無套性行為與自述為愛滋感染者三者密切相關。合併娛樂性藥物及邀約無套性行為愛滋感染風險高，未來建議針對男同志各式社交平台進行感染風險之宣導，避免因不知情之狀況下暴露於感染愛滋病毒之風險。

Internet-based chatrooms are popularly social networking platforms. The gay dating was easy to exposure in HIV risky behavior, and had unprotected sexual behavior with others unknown HIV infection status.The study purpose was to explore the correlation between the introduction of gay personal profile and HIV related risk behaviors. We recorded the introduction of gay dating users during one month in the UT chatroom. We definituded the keywords of the HIV infected association behaviors by expertise opinions. Then we analyzed the association between the personal dating profiles by SPSS software and associated rules try to find the association of personal introduction messages and HIV related risk behaviors. Totally analyzed 610,058 open personal dating profile in the gay chatroom. Of them, 17.2% were identified as the requests for sexual intercourse directly, 1.0% requested for bareback, only 0.9% disclosed their HIV positive status, 10.6% requested for using drugs, including 4.6% for methamphetamine, followed by MDMA (1.0%), ketamine (0.8%), and pepper (0.3%) by excluding repeated ID. Recreational drug using was associated with intentional bareback (aOR=4.16, 95% CI:3.93, 4.93). Self-report HIV status were associated with intentional bareback (aOR=1.94, 95% CI:1.64, 2.26) and recreational drug using (aOR=7.60, 95% CI:7.20, 8.03). The percentage of self-report HIV positive status during intentional bareback and recreational drug using was 50.5%. Self-reported HIV-infection, recreational drug using and intentional unprotected sexual behavior were positive correction with each other. Future HIV prevention strategies should emphasize on knowing keywords of HIV infected behaviors for key population avoiding to expose in risky situation.

中文摘要 I
英文摘要 II
致謝 IV
第一章 緒論 1
第一節 研究背景 1
第二節 研究動機與重要性 2
第三節 研究目的 3
第二章 文獻查證 5
第一節 男性間性行為者愛滋病毒感染流行病學描述 5
第二節 男同志網路社交行為描述 5
第三節 男同志網路行為與感染愛滋病毒之風險 6
第四節 男同志網路交友行為與愛滋病毒感染危險行為之描述 8
第五節 關聯性法則在健康照護之運用 9
第三章 研究方法 12
第一節 研究設計 12
第二節 研究對象與場域 13
第三節 愛滋病毒感染危險行為依變項定義 13
第四節 愛滋病毒感染危險行為自變項定義 15
第五節 倫理考量 16
第六節 資料統計分析 16
第四章 研究結果 19
第一節 男同志聊天室交友簡介人口學特質 19
第二節 雙峰時段與愛滋病毒感染危險行為之關聯 19
第三節 登入星期與感染危險行為之差異 20
第四節 休假娛樂時段與愛滋病毒感染危險行為之差異 20
第五節 愛滋感染行為與愛滋病毒感染之相關 20
第六節 愛滋病毒感染危險行為間之關聯性 20
第七節 邀約無套性行為之二元羅吉式迴歸分析 21
第八節 邀約娛樂性藥物之二元羅吉式迴歸分析 22
第九節 愛滋病毒感染之二元羅吉式迴歸 23
第十節 網路聊天室高頻率出現關鍵字之關聯性法則運算 24
第五章 討論 26
第一節 愛滋病毒感染者容易邀約無套性行為 26
第二節 娛樂性藥物使用者較常邀約無套性行為 28
第三節 邀約娛樂性藥物者其自述愛滋病毒感染比率高 29
第四節 自述愛滋病毒感染者較易使用娛樂性藥物 29
第五節 網路交友關鍵字與無套性行為之探討 31
第六節 研究限制 32
第六章 結論與建議 33
參考文獻 34

台灣網路資訊中心．(2012)．台灣寬頻網路統計查詢系統．取自 http://statistics.twnic.net.tw/cgi/login.cgi
台灣網路資訊中心．(2014)．2014 年「台灣寬頻網路使用調查」結果公布．取自 http://www.twnic.net.tw/NEWS4/135.pdf
吳國禎．(2000)．資料探索在醫學資料庫之應用．(碩士)，中原大學。
林伊亭、王綺嫻、蕭嘉士、顏永泰、許怡欣、劉立(2006)．運用資料探勘建構共患疾關聯模型-以痤瘡患者為例．台北醫學大學。
柯乃熒‧(2008)‧網路、搖頭與性的交錯青少年男同志感染HIV的風險‧愛之關懷季刊(63)，34-40。
疾病管制署(2016，1月7日)‧HIV月報105-05‧取自http://www.cdc.gov.tw/professional/info.aspx?treeid=3f2310b85436188d＆nowtreeid=2285B9745A0A3CBB＆tid=97D39D2BB81D32E9
陳昶勳．(2015, 104/6/27-28)．我國愛滋疫情現況與醫療照護網路．Paper presented at the 愛滋病個案管理師基礎核心教育訓練，台北市立聯合醫院昆明院區。
黃怡詔、鄭又銘(2011)．代謝症候群與生活型態之關聯性法則搜尋-以某PCB廠員工為例 (pp. 1-10)：第十四屆決策分析研討會
劉姵伶、高銓吟、黃彥芳、陳昶勳‧(2016)‧我國同志健康行為調查與同志健康社區服務中心推動成果‧疫情報導，32(10)，203-214。 doi:10.6524/eb.20160524.32(10).001
蔡孟哲‧(2015)‧愛滋病毒、派對藥物與酷兒壞情感：《愛我就趁夏天》的「毒∕藥」政治‧台灣學誌(11)，35-60‧doi:10.6242/twnica.11.3。
衛漢庭、陳牧宏‧(2014)‧男同志與安非他命使用：文獻回顧與臺灣的挑戰‧愛之關懷季刊(88)，6-13。
羅一鈞‧(2014)‧娛樂藥物使用對於愛滋防治及愛滋病毒感染者健康的影響－實例與國內研究‧愛之關懷季刊(88)，14-21。
Benotsch, E. G., Kalichman, S., ＆ Cage, M. (2002). Men who have met sex partners via the Internet: prevalence, predictors, and implications for HIV prevention. Archives of Sexual Behavior, 31(2), 177-183.
Blackwell, C. W. (2010). The relationship among population size, requests for bareback sex, and HIV serostatus in men who have sex with men using the Internet to meet sexual partners. Journal of Human Behavior in the Social Environment, 20, 349-360. doi:DOI: 10.1080/10911350903343925
Blackwell, C. W. (2016). The relationship among population size, requests for Bareback sex, and HIV serostatus in men who have sex with men using the Internet to meet sexual partners. Journal of Hunman Behavior in the Social Environment, 20, 349-360. doi:10.1080/10911350903343925
Brenner, J., ＆ Smith, A. (2013). 72% of Online Adults are social networking site users. Retrieved from http://www.pewinternet.org/2013/08/05/72-of-online-adults-are-social-networking-site-users/
Carballo-Dieguez, A., Dowsett, G. W., Ventuneac, A., Remien, R. H., Balan, I., Dolezal, C., . . . Lin, P. (2006). Cybercartography of popular internet sites used by New York City men who have sex with men interested in bareback sex. AIDS Education and Prevention, 18(6), 475-489. doi:10.1521/aeap.2006.18.6.475
Chen, X., Li, X., Zheng, J., Zhao, J., He, J., Zhang, G., ＆ Tang, X. (2015). Club drugs and HIV/STD Infection: an exploratory analysis among men who have sex with men in changsha, China. PLoS One, 10(5), e0126320. doi:10.1371/journal.pone.0126320
Chen, Y., Li, L., ＆ Xu, R. (2015). Disease comorbidity network guides the detection of molecular evidence for the link between colorectal cancer and obesity. AMIA Summits on Translational Science Proceedings, 2015, 201-206.
Cheung, K. T., Fairley, C. K., Read, T. R., Denham, I., Fehler, G., Bradshaw, C. S., . . . Chow, E. P. (2016). HIV Incidence and Predictors of Incident HIV among men who have sex with men attending a sexual health clinic in melbourne, Australia. PLoS One, 11(5), e0156160. doi:10.1371/journal.pone.0156160
den Daas, C., Goenee, M., Bakker, B. H., de Graaf, H., ＆ Op de Coul, E. L. (2015). Comparing databases: determinants of sexually transmitted infections, HIV diagnoses, and lack of HIV testing among men who have sex with men. BMC Public Health, 15, 1114. doi:10.1186/s12889-015-2445-3
Glick, S. N., Winer, R. L., ＆ Golden, M. R. (2013). Web-based sex diaries and young adult men who have sex with men: assessing feasibility, reactivity, and data agreement. Archives of Sexual Behavior, 42(7), 1327-1335. doi:10.1007/s10508-012-9984-9
Hall, M. G., Barrington, C. L., Chen, S. Y., Arambu, N., Morales, S., Miller, W., . . . Bailey, G. P. (2013). Respondent-driven sampling and time-location sampling: a comparison of implementation and operational challenges for HIV behavioral research in guatemala. Population Association of America 2013 Annual Meeting Program, 1-19.
Heijman, T., Stolte, I., Geskus, R., Matser, A., Davidovich, U., Xiridou, M., ＆ Schim van der Loeff, M. (2016). Does online dating lead to higher sexual risk behaviour? A cross-sectional study among MSM in Amsterdam, the Netherlands. BMC Infectious Disease, 16(1), 288. doi:10.1186/s12879-016-1637-5
Hospers, H. J., Kok, G., Harterink, P., ＆ de Zwart, O. (2005). A new meeting place: chatting on the Internet, e-dating and sexual risk behaviour among Dutch men who have sex with men. AIDS, 19(10), 1097-1101.
Ko, N. Y., Koe, S., Lee, H. C., Yen, C. F., Ko, W. C., ＆ Hsu, S. T. (2012). Online sex-seeking, substance use, and risky behaviors in Taiwan: results from the 2010 Asia Internet MSM sex survey. Archives of Sexual Behavior, 41(5), 1273-1282. doi:10.1007/s10508-012-9908-8
Ko, N. Y., Tseng, P. C., Huang, Y. C., Chen, Y. C., ＆ Hsu, S. T. (2016). Seeking sex partners through the internet and mobile phone applications among men who have sex with men in Taiwan. AIDS Care, 1-5. doi:10.1080/09540121.2015.1131969
Kutner, B. A., Nelson, K. M., Simoni, J. M., Sauceda, J. A., ＆ Wiebe, J. S. (2016). Factors associated with sexual risk of HIV transmission among HIV-positive Latino men who have sex with men on the U.S.-Mexico Border. AIDS Behavior. doi:10.1007/s10461-016-1449-z
Lai, F. Y., Bruno, R., Hall, W., Gartner, C., Ort, C., Kirkbride, P., . . . Mueller, J. F. (2013). Profiles of illicit drug use during annual key holiday and control periods in Australia: wastewater analysis in an urban, a semi-rural and a vacation area. Addiction, 108(3), 556-565. doi:10.1111/add.12006
Leon, L., Jauffret-Roustide, M., ＆ Le Strat, Y. (2015). Design-based inference in time-location sampling. Biostatistics, 16(3), 565-579. doi:10.1093/biostatistics/kxu061
Lewnard, J. A., ＆ Berrang-Ford, L. (2014). Internet-based partner selection and risk for unprotected anal intercourse in sexual encounters among men who have sex with men: a meta-analysis of observational studies. Sex Transm Infect, 90(4), 290-296. doi:10.1136/sextrans-2013-051332
Margolis, A. D., Joseph, H., Hirshfield, S., Chiasson, M. A., Belcher, L., ＆ Purcell, D. W. (2014). Anal intercourse without condoms among HIV-positive men who have sex with men recruited from a sexual networking web site, United States. Sex Transmitted Disease, 41(12), 749-755. doi:10.1097/olq.0000000000000206
Meade, C. S., Lion, R. R., Cordero, D. M., Watt, M. H., Joska, J. A., Gouse, H., ＆ Burnhams, W. (2016). HIV risk behavior among methamphetamine users entering substance abuse treatment in cape town, South Africa. AIDS and Behavior. doi:10.1007/s10461-016-1333-x
Nishijima, T., Gatanaga, H., Komatsu, H., Takano, M., Ogane, M., Ikeda, K., ＆ Oka, S. (2013). High prevalence of illicit drug use in men who have sex with men with HIV-1 infection in Japan. PLoS One, 8(12), e81960. doi:10.1371/journal.pone.0081960
Nodin, N., Valera, P., Ventuneac, A., Maynard, E., ＆ Carballo-Dieguez, A. (2011). The Internet profiles of men who have sex with men within bareback websites. Culture Health and Sexuality, 13(9), 1015-1029. doi:10.1080/13691058.2011.598946
Okafor, C. N., Cook, R. L., Chen, X., Surkan, P. J., Becker, J. T., Shoptaw, S., . . . Plankey, M. W. (2016). Trajectories of marijuana use among HIV-seropositive and HIV-seronegative MSM in the multicenter AIDS cohort study (MACS), 1984-2013. AIDS and Behavior. doi:10.1007/s10461-016-1445-3
Pollock, J. A., ＆ Halkitis, P. N. (2009). Environmental factors in relation to unprotected sexual behavior among gay, bisexual, and other MSM. AIDS Education and Prevention, 21(4), 340-355. doi:10.1521/aeap.2009.21.4.340
Poulin, C., Shiner, B., Thompson, P., Vepstas, L., Young-Xu, Y., Goertzel, B., . . . McAllister, T. (2014). Predicting the risk of suicide by analyzing the text of clinical notes. PLoS One, 9(1), e85733. doi:10.1371/journal.pone.0085733
Reback, C. J., Fletcher, J. B., Shoptaw, S., ＆ Grella, C. E. (2013). Methamphetamine and other substance use trends among street-recruited men who have sex with men, from 2008 to 2011. Drug and Alcohol Dependence, 133(1), 262-265. doi:10.1016/j.drugalcdep.2013.06.007
Rosenberg, E. S., Sullivan, P. S., Dinenno, E. A., Salazar, L. F., ＆ Sanchez, T. H. (2011). Number of casual male sexual partners and associated factors among men who have sex with men: results from the National HIV behavioral surveillance system. BMC Public Health, 11, 189. doi:10.1186/1471-2458-11-189
Sanchez, T., Zlotorzynska, M., Sineath, C., Kahle, E., ＆ Sullivan, P. (2016). The annual American men's Internet survey of behaviors of men who have sex with men in the United States : 2014 key indicators report. JMIR Public Health and Surveillance, 2(1), e23. doi:10.2196/publichealth.5476
Semaan, S. (2010). Time-space sampling and respondent-driven sampling with hard-to-reach populations. Methodological Innovations Online, 5(2), 60-75. doi:10.4256/mio.2010.0019
Shuper, P. A., Joharchi, N., ＆ Rehm, J. (2014). Personality as a predictor of unprotected sexual behavior among people living with HIV/AIDS: a systematic review. AIDS and Behavior, 18(2), 398-410. doi:10.1007/s10461-013-0554-5
Stall, R., Paul, J. P., Greenwood, G., Pollack, L. M., Bein, E., Crosby, G. M., . . . Catania, J. A. (2001). Alcohol use, drug use and alcohol-related problems among men who have sex with men: the Urban Men's Health Study. Addiction, 96(11), 1589-1601. doi:10.1080/09652140120080723
Togari, T., Inoue, Y., Takaku, Y., Abe, S., Hosokawa, R., Itagaki, T., . . . Yajima, T. (2016). Recreational drug use and related social factors among HIV-positive men in Japan. AIDS Care, 28(7), 932-940. doi:10.1080/09540121.2016.1140888
Traeen, B., Noor, S. W., Hald, G. M., Rosser, B. R., Brady, S. S., Erickson, D., . . . Wilkerson, J. M. (2015). Examining the relationship between use of sexually explicit media and sexual risk behavior in a sample of men who have sex with men in Norway. Scandinavian Journal of Psychology, 56(3), 290-296. doi:10.1111/sjop.12203
Tsui, H. Y., ＆ Lau, J. T. (2010). Comparison of risk behaviors and socio-cultural profile of men who have sex with men survey respondents recruited via venues and the internet. BMC Public Health, 10: 232. doi:doi: 10.1186/1471-2458-10-232
Vosburgh, H. W., Mansergh, G., Sullivan, P. S., ＆ Purcell, D. W. (2012). A review of the literature on event-level substance use and sexual risk behavior among men who have sex with men. AIDS Behav, 16(6), 1394-1410. doi:10.1007/s10461-011-0131-8
Winetrobe, H., Rice, E., Bauermeister, J., Petering, R., ＆ Holloway, I. W. (2014). Associations of unprotected anal intercourse with Grindr-met partners among Grindr-using young men who have sex with men in Los Angeles. AIDS Care, 26(10), 1303-1308. doi:10.1080/09540121.2014.911811
UNAIDS. (2015). The Fast-Track ending the AIDS epidemic by 2030. Retrieved from http://www.unaids.org/en/resources/documents/2014/JC2686_WAD2014report
UNAIDS. (2016). Fack sheet global stastistics 2015. Retrieved from http://www.unaids.org/en/resources/fact-sheet.
Vosburgh, H. W., Mansergh, G., Sullivan, P. S., ＆ Purcell, D. W. (2012). A review of the literature on event-level substance use and sexual risk behavior among men who have sex with men. AIDS and Behavior, 16(6), 1394-1410. doi:10.1007/s10461-011-0131-8
Wei, C., Guadamuz, T. E., Lim, S. H., Huang, Y., ＆ Koe, S. (2012). Patterns and levels of illicit drug use among men who have sex with men in Asia. Drug and Alcohol Dependence, 120(1–3), 246-249. doi:http://dx.doi.org/10.1016/j.drugalcdep.2011.07.016
Wei, C., Lim, S. H., Guadamuz, T. E., ＆ Koe, S. (2014). Virtual versus physical spaces: which facilitates greater HIV risk taking among men who have sex with men in East and South-East Asia? AIDS Behav, 18(8), 1428-1435. doi:10.1007/s10461-013-0628-4
Winetrobe, H., Rice, E., Bauermeister, J., Petering, R., ＆ Holloway, I. W. (2014). Associations of unprotected anal intercourse with Grindr-met partners among Grindr-using young men who have sex with men in Los Angeles. AIDS Care, 26(10), 1303-1308. doi:10.1080/09540121.2014.911811
World Health Organization. (2014a). HIV prvention, diagnosis, treatment and care for key populations. Retrieved from http://www.acon.org.au/wp-content/uploads/2015/04/WHO-guidelines-on-HIV-prev-diag-treat-and-care-for-key-populations-2014.pdf
World Health Organization . (2014b). Policy brief: consolidated guidelines on HIV prevention, diagnosis, treatment and care for key populations. Retrieved from http://www.who.int/hiv/pub/toolkits/keypopulations/en/
World Health Organization . (2015). HIV/AIDS. Retrieved from http://www.who.int/hiv/en/