討論與建議

建議採取的措施包含：口交時使用保險套、拳交時使用手套、舌肛吻時使用口交 膜或自製薄膜(將保險套剪開後攤開)等方式都能降低風險[21]，但這些措施在實務 上執行並不容易，尤其是在用藥後危機意識降低、戴套不舒服更會增加不安全的 性行為的機率。

針對桿菌性痢疾成為我國 HIV 感染者族群之新興傳染病的現象，疾管署已透 過新聞稿、社群媒體分眾宣導、通函提醒愛滋指定醫院及民間團體等方式，提醒 高風險族群與愛滋照護團隊注意警訊，同時應該呼籲臨床醫師在診治年輕男性族 群的腹瀉症狀時，應審慎評估相關感染危險因子，尤其是曾診斷過梅毒的案例，

若有相關症狀就診時應增加其他篩檢項目：如 A 型肝炎、C 型肝炎、阿米巴痢疾、

桿菌性痢疾，並適時進行通報並給予相關衛教，包含個案定時服藥及複診等。

關於這個新出現的傳播途徑可能在男男間性行為族群中造成流行，並威脅 HIV 感染者的健康，除了前述的宣導措施，本研究建議持續監測流行病學趨勢，

及時公布監測結果，進一步研究相關行為因子及預防方法，且未來在醫事人員的 持續教育中，強調桿菌性痢疾可能經由性行為傳播的感染途徑。並且針對非境外 移入桿菌性痢疾個案，在個案調查中加入愛滋病史詢問或愛滋血清檢查 、性行為 模式和接觸對象的追蹤，提供對於性行為和藥物的健康風險諮詢，以降低國內桿 菌性痢疾的傳播。

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