用大模型帮药物使用者获取安全有用的信息,关键在合作设计与伦理把控。
Positioning AI Tools to Support Online Harm Reduction Practice: Applications and Design Directions
- 通过多方协作工作坊,探索大模型在减害信息中的实用场景。
- 大模型可实现多语言响应、减少污名化,但需解决上下文理解难题。
- 适合关注数字健康、社会公平和负责任AI的从业者与研究者。
药物使用者(PWUD)获取准确且可操作的减害信息,直接影响其健康结果。然而现有在线渠道因适应性差、可及性低及污名化影响,难以满足其多样化和动态化的需求。大型语言模型(LLMs)为提升信息提供能力带来新机遇,但在高风险领域应用仍缺乏探索,并面临复杂的社会技术挑战。本文通过包含学术界、减害实践者及在线社区管理员在内的多群体定性工作坊,探讨了LLM的能力边界、潜在应用场景及核心设计考量。研究发现,尽管LLMs能缓解部分信息障碍(如支持实时响应、多语言交流和降低污名感),但其有效性依赖于对减害原则的伦理对齐、细微情境理解、有效沟通机制以及明确的操作边界。本文提出应通过与专家和药物使用者共同设计,构建有益、安全且受控的LLM系统。本研究提供了实证基础和可操作的设计建议,推动大模型在减害生态中的负责任发展。
原文摘要 · Abstract (English)
Access to accurate and actionable harm reduction information can directly impact the health outcomes of People Who Use Drugs (PWUD), yet existing online channels often fail to meet their diverse and dynamic needs due to limitations in adaptability, accessibility, and the pervasive impact of stigma. Large Language Models (LLMs) present a novel opportunity to enhance information provision, but their application in such a high-stakes domain is under-explored and presents socio-technical challenges. This paper investigates how LLMs can be responsibly designed to support the information needs of PWUD. Through a qualitative workshop involving diverse stakeholder groups (academics, harm reduction practitioners, and an online community moderator), we explored LLM capabilities, identified potential use cases, and delineated core design considerations. Our findings reveal that while LLMs can address some existing information barriers (e.g., by offering responsive, multilingual, and potentially less stigmatising interactions), their effectiveness is contingent upon overcoming challenges related to ethical alignment with harm reduction principles, nuanced contextual understanding, effective communication, and clearly defined operational boundaries. We articulate design pathways emphasising collaborative co-design with experts and PWUD to develop LLM systems that are helpful, safe, and responsibly governed. This work contributes empirically grounded insights and actionable design considerations for the responsible development of LLMs as supportive tools within the harm reduction ecosystem.
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