後疫時代人類免疫缺陷病毒醫療照護者需具備的照護思維

Post COVID-19 Pandemic Care for HIV Caregivers

2020年橫掃全球的新冠病毒，讓全球體會了傳染病的重大負面影響，也重新讓醫療照護人員思考疾病照護的烙印。在台灣人類免疫缺陷病毒（HIV）感染者經由高效能抗愛滋病毒治療之後，目前已是ㄧ種慢性病。由於感染HIV病毒與行為相關，感染者常被以負面形象呈現，承受多重刻板印象及愛滋污名。在台灣HIV感染者之污名深受東方哲學儒家文化的影響，使感染者面臨的污名情形與西方文化有所不同。目前HIV的治療觀念是病毒量測不到等於不會傳染（Undetectable = Untransmittable, U = U），故在後疫時代HIV醫療照護人員應該具備有實證的照護思維，本篇文章介紹儒家思想下的HIV污名、HIV U = U的治療概念及後疫時代HIV醫療照護人員該具備的照護思維，期盼能提供給HIV感染者無歧視的醫療照護，讓台灣能儘早達成聯合國愛滋病規劃署2030年對全球愛滋病防治零歧視、零感染、零死亡的三零的願景。

The COVID-19 pandemic that swept the world in 2020 has highlighted the dangers and challenges posed by infectious diseases and encouraged healthcare providers to further re-think the stigma of epidemic and pandemic diseases. HIV infection was reclassified as a chronic disease in Taiwan after highly active antiretroviral therapy was introduced in the country. Because HIV infection is related to behavior, people living with HIV are often affected by a negative social image that is influenced by multiple stereotypes and the general stigma toward AIDS. In Taiwan, this stigma is deeply influenced by Eastern philosophy and Confucian culture, making the context and effect of stigma different from Western countries. The current“U=U”concept of HIV treatment holds that someone under treatment for HIV with an undetectable HIV viral load cannot sexually transmit the virus to others. Therefore, in the post-pandemic era, HIV medical care personnel should apply evidence-based-care thinking. This article describes HIV stigma in the context of Confucianism, U=U as the leading concept of HIV treatment, and the recommended approach to care for HIV healthcare practitioners in the post-COVID-19 era. Reducing HIV stigma will enable Taiwan to achieve the‘Three Zeros’of zero discrimination, zero infection, and zero death advocated by the Joint United Nations Program on HIV/ AIDS for ending the AIDS epidemic by 2030.