醫療專業人員對愛滋病人烙印之倫理變遷

Ethical Changes of Stigma toward AIDS Patients among Medical Professionals

愛滋病人隨著高效能反轉錄病毒療法普遍使用，存活期及預後改善朝向慢性病發展，病人社會及心理問題仍有極大改善空間。國內早期研究顯示醫師及護理師因愛滋病教育訓練及血體液感染防治設備不足，因靜脈藥癮、同性戀等負向觀感對愛滋病人產生烙印，若強制醫療專業人員安排照顧則會選擇離職，罔顧身為醫療專業人員之專業倫理。本篇文章介紹醫療專業人員對愛滋病人烙印之變遷，隨著社會風氣改變及婚姻平權及醫療代理人之探討、愛滋病在職教育普及、學校教育提供照護倫理課程、實務及情境模擬演練、臨床專業問題探討及以病人為中心之情境討論，醫療專業人員對愛滋病人整體負向觀感改變，對於傳染途徑的風險掌握與知覺更加理性，期許能達成聯合國 2030 年對於愛滋病人零歧視的願景。

With the widespread use of highly active antiretroviral therapy as treatment, survival and prognosis of HIV-infection have improved significantly. It has been a chronic disease since then. HIV carries a negative perception such as intravenous drug addiction and homosexual. Efforts are needed to improve patients' social and psychological problems. Early research showed that physicians and nurses used to carry a negative attitude toward patients with HIV infection due to inadequate prevention strategies and lack of education training. Mandatory required medical staff caring for HIV patients usually leads to high turnover of personnel. This article described the changes of stigma, along with the changes in social climate, homosexual marriage rights, popularity of in-service AIDS education, ethics courses in nursing education, and patient-centered practices in clinics. We hope that medical professionals would change the negative attitude toward AIDS patients, becoming more reasonable and understanding the risk of infection, achieving the goal of zero discrimination advocated by the Joint United Nations Vision Programme on HIV/AIDS patients for ending the AIDS epidemic in 2030.