訃告
資料來源:刺胳針醫學期刊,http://www.thelancet.com/,財團法人台灣紅絲帶基金會編譯
大衛.斯圖爾特
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領導全球的愛滋病毒活動家和研究人員,努力減少藥愛性行為的危害。
他於 1967 年 1 月 28 日出生於南澳洲阿德萊德,於 2022 年 1 月 10 日在英國倫敦去世,享年54 歲。,
Chemsex 和 HIV 倡導者 David Stuart 藉鑑於自己過去的用藥的經歷和早期挑戰性之生活經歷,幫助大多數男男性行為者 (MSM) 減少藥愛(chemsex) 的危害。許多同行稱讚他創造了 chemsex 一詞——使用非法藥物來增強性體驗,這可能和風險行為的增加和不利的健康影響等有關。 2015 年,斯圖爾特出現在Chemsex紀錄片中,一部對高風險 chemsex 行為無情揭露的影片。
斯圖爾特堅持不懈地強調chemsex 之嚴重程度並支持那些受影響的人。他花了十多年的時間在英國倫敦的一系列環境中從事藥物治療服務工作——首先,從 2007 年到 2014 年,作為一名志願工作者,在倫敦之友(一家針對LGBTQI+ 健康和福祉之慈善機構the Antidote Substance Misuse Service)擔任物質濫用服務中心的志工。然後,他成為倫敦迪恩街(Dean Street)診所的藥物濫用主管,他在那裡工作了 8 年,其中包括領導其 CODE 診所的時期,該診所與 Antidote 合作提供減害和藥愛性行為之支持服務。David Asboe 是NHS 基金會信託基金之切爾西和威斯敏斯特醫院的愛滋病毒、性健康和皮膚病學之臨床主任,迪恩街診所是其中的一部分,並在迪恩街診所與 Stuart 進行了廣泛的合作。「大衛是他工作領域上的先驅,並將他的時間奉獻成為倡導者、活動家、支持工作者、活動家、講師和研究員」,Asboe在代表迪安街診所Stuart 的所有同事們向《剌胳針》發表的一份聲明中說。 「他是一位知名且受人尊敬的同事,也是我們許多人的朋友,他以熱情、同理心和善良對同性戀、雙性戀和酷兒社群的不懈工作而在國際上得到高度認可。大衛所做的工作無疑挽救了許多人的生命,而他的離世是對我們所有人來說都是無法估量的」。
在 進入2000 年代的第二個十年中,倫敦和全球其他主要城市的藥愛情景呈現爆炸式增長,斯圖爾特的時間需求也是如此。然而,他始終致力於讓每位患者在離開他的辦公室時的狀態都比他們進入其辦公室時更好。 2013 年初,他與《剌胳針》醫學雜誌在一份世界報告中討論了甲基安非他命等非法藥物,如何被一些於處理其羞恥和脆弱問題的男男性行為者所使用。他的眾多才能之一是能夠支持那些從事藥愛性行為的人找到擺脫成癮的方法。他堅定不移地專注於協助患者應對纏繞在他們吸毒的複雜因素,並及時結束他們於性上對藥物的依賴,如果這是他們期待的目標的話。而如果他們無法做到這一點,他也會建議他們如何建立安全網並更安全地使用藥物。斯圖爾特過逝後在社交媒體上向他致敬的人,包括許多受他幫助改變生活的人,以及那些他試圖幫助卻仍失去生命者的家人。斯圖爾特將因他在支持那些陷於自我獨特藥愛情境中掙扎之患者時的同情心、永無止境的可用性和其同理心而被人們所銘記——他們每個人都迫切需要一雙援手,並且總是能夠透過斯圖爾特敞開的大門而獲得。
他除了給予這麼多人的關心和支持外,斯圖爾特也在為解決藥愛之危害相關策略之全球倡議上,在會議上發言、合作撰寫研究論文,並為政府提供建議。他的貢獻包括為醫療保健提供者提供了藥愛及C型肝炎之指引,和許多關於多重藥物使用、藥愛性行為和 HIV 風險行為以及HIV暴露前預防如何影響藥愛動態之文章。 「大衛.斯圖爾特富有遠見的激進主義和對藥愛性行為的研究對於理解並將這一現象納入公共衛生和愛滋病議題上至關重要,這種現象如今正日益影響全球同性戀、雙性戀、跨性別和酷兒社群的生活」,於瑞士日內瓦的聯合國愛滋病規劃署之民間社會網絡高級顧問Cleiton Euzebio de Lima 說道。「透過他在迪恩街診所的工作,他明確地證明了同儕主導、非評判性和量身定制之服務在愛滋病毒預防和減害計劃上的成功。他的遺產將透過愛滋病毒/愛滋病之回應和世界各地的 LGBTQI+ 社群而持續永存」。
Obituary
David Stuart
HIV activist and researcher who led global efforts to reduce the harms of chemsex.
He was born on Jan 28, 1967 in Adelaide, SA, Australia, and died on Jan 10, 2022 in London, UK, aged 54 years.
Chemsex and HIV advocate David Stuart drew on his own past experiences of drug use and challenging early life experiences to help mostly men who have sex with men (MSM) reduce the harms of chemsex. Many peers have credited him with coining the term chemsex—the use of illicit drugs to enhance sexual experiences, which can be associated with increased risk behaviours and adverse health effects. In 2015, Stuart featured in the documentary Chemsex, a ruthless exposé of high-risk chemsex behaviour.
Stuart worked relentlessly to highlight the extent of chemsex and to support those affected. He spent more than a decade working in drug treatment services in a range of settings in London, UK—firstly, from 2007 to 2014, as a volunteer at the Antidote Substance Misuse Service, based at London Friend, an LGBTQI+ health and wellbeing charity. He then became the Substance Misuse Lead at the Dean Street Clinics in London, where he had worked for the past 8 years, including a period leading its CODE clinic, which provides harm reduction and chemsex support services, in partnership with Antidote. David Asboe is the Clinical Director of HIV, Sexual Health, and Dermatology at Chelsea and Westminster Hospital NHS Foundation Trust, of which the Dean Street Clinics are part, and worked extensively with Stuart at Dean Street. “David was a pioneer in his work and dedicated his time as an advocate, activist, support worker, campaigner, lecturer, and researcher”, said Asboe in a statement to The Lancet on behalf of all of Stuart’s colleagues at Dean Street. “He was a well known and respected colleague and friend to many of us, and highly recognised internationally for his tireless work with Gay, Bi, and Queer communities which he did with passion, empathy, and kindness. David’s work has undoubtedly saved the lives of many and his loss is
immeasurable to all of us.”
During the second decade of the 2000s, the chemsex scene in London and other major global cities exploded, as did the demands on Stuart’s time. Yet he would always aim to make each patient leave his office in a better state than they entered. Early in 2013, he discussed with The Lancet in a World Report how illicit drugs such as methamphetamine were used by some MSM who were dealing with shame and vulnerability issues. Among his many talents was the ability to support those engaged in chemsex to find a way through addiction. He steadfastly focused on helping patients cope with the complex factors surrounding their drug use, and, in time, end their dependence on drugs for sex, if that was their goal. When this was not possible, he would advise them how to use drugs more safely and establish safety nets. The tributes to Stuart on social media after his death include many from individuals whose lives he helped turn around, and family members of those who were lost while he tried to help them. Stuart will be remembered for his compassion, never-ending availability, and understanding when supporting patients who were struggling with their own unique chemsex situation—each of them in desperate need of a helping hand, and always able to walk through Stuart’s open door.
Alongside the care and support he gave to so many people, Stuart became a global advocate for strategies to address the harms associated with chemsex and spoke at conferences, collaborated on research papers, and advised governments. His contributions included a guide for health care providers on chemsex and hepatitis C, papers on the effect of polydrug use, chemsex, and HIV risk behaviour, and how HIV pre-exposure prophylaxis affected the dynamics of chemsex. “David Stuart’s visionary activism and research on chemsex was fundamental to understand and bring onto the public health and HIV agenda this phenomenon that, today, is increasingly affecting the life of gay, bisexual, trans and queer communities worldwide”, said Cleiton Euzebio de Lima, Senior Adviser for Civil Society Networking at UNAIDS, Geneva, Switzerland. “Through his work at the Dean Street Clinics, he definitively demonstrated the importance of
peer-led, non-judgmental, and tailored services to the success of HIV prevention and harm reduction programmes. His legacy will live on through the HIV/AIDS response and in LGBTQI+ communities around the world.”