暴露前預防性投藥(Pre-exposure Prophylaxis, PrEP)是近年來新型態的愛滋防治方法。此藥物的預防效果主要依據服藥遵從性(medication adherence)。可能會因為服用者錯誤的服藥方式，導致PrEP效用不如預期。台灣於2016年開始推動PrEP預防策略，但繁複的工作內容及人力不足造成PrEP管理師在管理上的困難，且男男間性行為者（men who have sex with men，MSM）因為在藥物服用上遭遇各種困難而無法達到良好的服藥遵從性，導致暴露於感染的風險之中。因此本研究為了進一步了解上述兩個族群在PrEP藥物遵從的問題上而進行設計。本研究的設計過程首先針對MSM及PrEP管理師進行訪談，經過主題式分析方法分別整理出關於基本工作資訊、工作困境之因素、MSM常見問題以及醫病相處模式等四大主題說明PrEP管理師工作內容及其所面臨的困境；以及MSM在自我保護的態度與行動、服藥現象、低服藥遵從性之因素、軟體使用習慣及醫療服務的正向體驗等五個服藥經驗及困難主題。另外再透過參與式設計工作坊(Participatory Design Workshop)，邀請MSM、PrEP管理師、設計師、公衛專家等不同角色來參與討論並發想符合目標需求族群的手機應用程式(APP)的功能概念，包含PrEP資訊提供、社群功能、提醒功能、資訊視覺化等主要功能概念來作為後續產品設計之參考。

Over recent years, Pre-exposure Prophylaxis (PrEP) has become a promising, new HIV prevention strategy, whose effectiveness depends strongly on users’ level of medication adherence. However, an inappropriate dosing regimen might lead to lower-than-expected efficacy . Since Taiwan began implementing a wide PrEP program in 2016, PrEP navigators have been confronted with management challenges in all aspects, such as heavy workloads and the manpower shortage in handling PrEP adherence; in addition, MSM might be put in a high risk of HIV infection due to their low drug adherence, usually driven by the complication in taking medications. To have a better understanding of the above problems existing among the two groups, an interview and a workshop are therefore conducted. At the beginning of this study, we conduct several in-depth interviews with MSM and PrEP navigators. To interpret PrEP navigators’ responsibilities and challenges, we collect data and sort it into four themes: Basic PrEP-related Information, Factors causing the Dilemma, FQA from MSM, and Doctor-Patient Relationship. Likewise, to explain MSM’s medication experience and obstacles, five themes are named as follow: MSM’s Attitudes and Action towards Self-protection, MSM’s Medication Process and Changes, Factors Causing MSM’s Low PrEP Adherence, Apps Usage, as well as Excellent Experiences from Medical Services. Next, at the Participatory Design Workshop, both MSM and PrEP navigators are invited to discuss the themes from their perspectives and help come up with some of the feature concepts for cell phone applications to meet the practical needs of the target groups. The feature concepts including comprehensive PrEP information, online community, adherence reminder systems, and information visualization will then serve as design references for the following products.

第一章、緒論 7
第一節 研究背景與動機 7
第二節 研究目的 11
第三節 預期貢獻 12
第四節、論文架構 12
第二章、文獻探討 14
第一節 藥物遵從性之定義與測量方法 14
第二節 先前改善服藥遵從性的方法 15
第三節 國外PrEP 應用程式的發展 16
第四節 理論為基礎的介入策略 22
第五節 小結 24
第三章、訪談之研究方法與分析結果 25
第一節 研究方法：深度訪談法 26
第二節 訪談分析 30
第三節 結果與討論 64
第四章、參與是設計工作坊之研究方法與分析結果 67
第一節 參與式設計工作坊流程設計 67
第二節 參與式設計工作坊成果 75
第三節 結果與討論 82
第五章、結論與建議 87
第一節 研究結論 88
第二節 研究貢獻 90
第三節 研究建議 92
參考文獻 94
中文文獻 94
英文文獻 95
附錄一：PrEP管理師訪談計畫與大綱 98
附錄二：MSM訪談計畫與大綱 102

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