靜脈注射藥癮族群增加人類免疫缺乏病毒感染除了危險的注射行為，另一個是高危險的性行為，而未保護的性行為是增加靜脈注射藥癮者及其性伴侶感染人類免疫缺乏病毒的危險因素，但這部份比起注射危險行為卻較少引人注意。本研究引用資訊-動機-行為技能模式（IMB model）作為理論架構，以了解中部某醫學中心收治之美沙冬替代治療的藥癮者其性生活與保險套使用行為並分析影響使用保險套之相關因素。研究對象為台中市某醫學中心美沙冬特別門診病人，共有192位（男性142位，女性50位）藥癮者參與研究。測量工具參考國內外文獻及IMB模式的理論架構編製而成之結構性問卷，統計方法以卡方檢定、獨立樣本t檢定及Pearson’s積差相關分析各變項間的相關情形及MPlus的結構方程式分析IMB模式與保險套使用行為之間各變項間關係及預測力。
研究結果為：（1）研究對象有99％有過性經驗，第一次的性行為平均年齡17.78歲，且第一次性行為高達73.2％沒有使用保險套（2）在海洛因期間、訪談前一個月及訪談後一個月等不同時期的性生活及保險套使用行為，皆以固定性伴侶為最多，擁有一人以上的伴侶以男性多於女性，性伴侶同為藥癮者則以女性多於男性（3）不論性伴侶為固定性伴侶或偶發性伴侶，沒有使用保險套的原因以手邊沒有、沒有必要使用及不喜歡用為共有原因（4）HIV篩檢結果為陽性者比陰性者有較多的保險套使用（5）與固定性伴侶發生性行為時在比率上有較少使用保險套的情形，保險套的不舒服感及使用及購買的麻煩確實會影響研究對象保險套的使用頻率（6）性功能障礙、保險套使用及性伴侶人數在美沙冬治療前後有顯著差異，治療後優於治療前（7）透過Mplus的結構方程式分析，IMB模式與研究實際資料適合度良好，行為技能可被愛滋病預防相關資訊及保險套使用動機解釋的變異量為75％，訪談後一個月的性行為模式可以被愛滋病預防相關資訊、保險套使用動機及使用保險套的相關行為技能解釋的變異量為52％。
本研究的建議為：（1）進行長期研究：本研究僅是先驅研究，未來希望能就研究結果設計介入性教材，以改善HIV預防的資訊、動機、行為技能及保險套使用行為，最終進行評價性研究了解介入性教育的效果（2）衛生教育模式的改變：衛生教育不只是講述性的知識提供，必須建立一套以藥癮者為主的態度、動機改變及行為技能提升訓練課程，達到藥癮者的賦能（empowerment）（3）介入教材的制定（4）保險套宣導策略的改變（5）落實藥癮者尿液篩檢追蹤（6）性功能障礙的處置。

The purpose of this study is that to know the circumstances of sexuality and condom using among Methadone substitution treatment attendants. The researcher applied IMB Model to analyze the participants’ behaviors. The research is focus on the factors which affect the condom using rate of the participants. The analysis is based on 192 questionnaires (male: 142 people, female: 50 people). The participants were heroin-addicted individuals and also the outpatient of the medical center in Tai-Chung City. The methods of statistical analysis are Chi-square, t-test, Pearson’s product-moment correlation, and structural equation modeling (Mplus).
The results are:（1）99％ of participants have intercourse experiences. Their first experiences happened at the average age 17.78 years old. 73.2% of them did not use condom at their first intercourse.（2）During using heroin periods and one month before and after this survey, the participants’ sexual relationships are almost monogamous. Male were more likely to have multiple sexual partners than female do. Conversely, female had more high-risk sexual partners such as drug users.（3）There are three reasons for not using condom when the participants had been doing intercourse: condom was not available when they started sexuality, it was not necessary to use condom, and participants didn’t like to use condom.（4）Compare to HIV negative participants, HIV positive participants were reported greater rate of using condoms.（5）IDUs were less likely to use condoms with their primary sexual partners. The rate of using condom among IDUs is decreased by feeling of discomforted, experiencing inconvenience of purchase and use.（6）There are significant differences of sexual dysfunction, the rate of using condom, and numbers of sex partners between Methadone substitution treatment. Their situations are improved after Methadone substitution treatment.（7）MPlus demonstrated that IMB Model are compatible with the data. IMB Model explained approximately 75% of the variance in behavioral skills and 52％ of the variance of using condom during one month after this survey.
It is suggested that:（1）Conducting long-term research could be considered.（2）Improving IDUs’ attitudes, motivations and behavioral training is more important than verbal education. Hopefully, IDUs could have abilities of controlling their behaviors.（3）It’s the reference of designing the teaching tools.（4）The promotions of condom using need to be changed.（5）Following up the urine test of IDUs.（6）Introducing the treatment of sexual dysfunction.

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