資訊需求與暴露的族群間差異：對男男間性行為者進行愛滋防治的啟示

Group differences in the need for messages and exposure to messages: implications for HIV/AIDS prevention and control among men who have sex with men

目標：探討三個男男間性行為次族群對性健康、心理健康、及娛樂與健康宣導訊息的需求與暴露情形，並比較暴露與期望間的落差。方法：透過立意及滾雪球取樣招募受訪者，以自填式問卷調查收集資料。根據藥物使用及對男男間性行為者次文化參與的差異，將研究對象分為風險、同志認同資淺、及一般族群，並以後者為比較的參考組。結果：本研究共招募558位受訪者。整體而言，各族群對所有訊息的暴露比例都低於期望。風險族群和一般族群暴露於各議題的差異不大，然前者在藥物安全及娛樂資訊之暴露—期望落差較小。特別的是，風險族群在許多議題都顯示較高的過度滿足需求。比起另外兩個族群，資淺族群對各項訊息的暴露最為貧乏，具有程度最大且最廣泛的未滿足需求。結論：不同男男間性行為者次族群在愛滋防治宣導的資訊需求與暴露情形的確存在差異。建議應根據不同族群的暴露—期望情形提供量身訂做的訊息設計，加強未滿足需求資訊的提供，並針對過度滿足需求之資訊加以轉化或包裝，以增進宣導傳播效果。

Objectives: To examine the need for and exposure to message content related to sexual health, mental health, and entertainment and health among three groups of men who have sex with men (MSM), and compare the gaps between campaign exposure and expectations. Methods: We recruited participants through purposive and snowball sampling and collected data with a self-administered survey. Based on differences in drug use and participation in the MSM subculture, participants were further divided into risky, junior, and general MSM groups, with the latter as the reference group. Results: We recruited a total of 558 MSM in this study. Overall, for all content domains, message exposure was lower than expectation (need). Trivial differences were found between the risky and general groups in their exposure to various messages; however, the risky group had a smaller exposure-expectation gap for messages directed to 'safer drug use' and 'leisure and entertainment.' The risky MSM group had 'over-satisfied' needs in several domains. Compared with the other two groups, the junior MSM group had much poorer message exposure across a broad range of message domains' in that their unmet needs were highest in intensity and breadth. Conclusions: The need for messages and exposure to messages as part of an HIV/AIDS prevention campaign varied among different MSM subgroups. In addition to providing tailored message content and design to different groups by taking into account their exposure-expectation conditions, we should also provide more information to resolve unmet needs, and reframe and repackage messages recognized as over-satisfying needs in order to increase the effectiveness of campaigns.