Analysis of the suicidal behavior and psychosocial factors among HIV positive patients in Guangzhou
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摘要:
目的 了解广州市艾滋病病毒阳性者自杀意念和自杀行为现状，探讨其影响因素，分析社会心理因素与之的相关性。 方法 在广州市六区抽取HIV阳性成人患者进行横断面调查，收集社会人口学特征、HIV感染情况、自杀意念、自杀行为、社会心理因素等信息，以自杀意念、自杀行为为因变量，进行单因素和多因素Logistic回归分析。 结果 464名调查对象中，5.2%和17.4%分别有过自杀行为与自杀意念。其中，感染途径、抑郁、焦虑、社会歧视、自我歧视与自杀行为的发生有关（均有P < 0.05）；年龄、健康状况、配偶感染、抑郁、焦虑、社会支持、社会歧视、自我歧视与自杀意念的发生有关（均有P < 0.05）。多因素logistic回归分析模型显示抑郁、自我歧视与自杀行为发生有关（均有P < 0.05），抑郁、社会歧视与自杀意念发生有关（均有P < 0.05）。 结论 广州市HIV阳性成人患者的自杀意念与行为发生率较高，应在HIV阳性者中针对性地开展抑郁、社会歧视、自我歧视相关的心理咨询、风险评估并尽早干预治疗。 Abstract:Objective To investigate the status of suicidal behaviors and suicidal ideation among HIV positive patients in Guangzhou, and to explore its relevant psycho-social factors. Methods We conducted a cross-sectional survey of HIV positive adult patients in six districts of Guangzhou to collect social-demographic characteristics, HIV infection time, suicidal ideation, suicidal behaviors and psycho-social factors. Use suicidal ideation and suicidal behaviors as the dependent variables to conduct the univariate analysis and multivariate Logistic regression analysis. Results Of the 464 subjects, 5.2% and 17.4% of them had suicidal behaviors and suicidal ideation. Analysis showed that the infection route, depression, anxiety, social discrimination, self-discrimination were correlated with the suicidal behaviors(all P < 0.05), while age, health status, spouse infection, depression, anxiety and social support, social discrimination, self-discrimination were correlated with the suicidal ideation(all P < 0.05). Multivariate Logistic regression model showed that depression and self-discrimination were associated with suicidal behaviors(all P < 0.05), depression and social discrimination were associated with suicidal ideation (all P < 0.05). Conclusions HIV-positive adult patients in Guangzhou have a high incidence of suicidal ideation and behaviors. Psychological counseling, risk assessment and timely treatment related to depression, social discrimination self-discrimination and early antiviral treatment should be targeted in HIV-positive adult patients. -
Key words:
- HIV /
- Suicide /
- Psycho-social factors
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表 1 社会心理学因素与自杀行为、自杀意念之间的关系
Table 1. Relationship between social psycho-social factors and suicidal behavior and suicidal ideation
社会心理学
因素自杀行为 自杀意念 例(%) ORu(95% CI)值 ORm(95% CI)值 例(%) ORu(95% CI)值 ORm(95% CI)值 抑郁 轻度 3(0.9) 1.00 1.00 29(9.0) 1.00 1.00 中度 8(11.8) 14.33(3.78~54.33)a 13.41(3.52~51.11)a 18(23.7) 3.15(1.64~6.04)b 3.02(1.52~6.01)b 重度 12(18.5) 24.15(6.59~88.45) a 22.00(5.96~81.24)a 34(52.3) 11.12(5.99~20.64)a 10.78(5.31~21.91)a 焦虑 轻度 10(2.6) 1.00 1.00 45(11.7) 1.00 1.00 中度 7(11.7) 4.94(1.80~13.53)b 4.82(1.74~13.39)b 24(40.0) 5.02(2.75~9.18)a 4.35(2.27~8.33)a 重度 7(35.0) 20.14(6.62~61.29)a 18.17(5.88~56.12)a 12(60.0) 11.30(4.38~29.13)a 9.16(3.18~26.39) a 社会支持 家庭支持 - 0.77(0.59~1.01)c 0.78(0.59~1.03)c - 0.81(0.69~0.95)b 0.83(0.70~0.98)d 朋友支持 - 0.84(0.63~1.12) 0.81(0.60~1.10) - 0.76(0.64~0.91)b 0.79(0.66~0.96)d 重要他人支持 - 0.83(0.62~1.12) 0.81(0.59~1.12) - 0.79(0.66~0.95)d 0.82(0.68~1.00)d 社会歧视 - 0.47(0.22~1.02)c 0.43(0.19~0.97)d - 0.37(0.23~0.60)a 0.31(0.18~0.52)a 自我歧视 - 4.93(2.46~9.88)a 5.55(2.68~11.49)a - 2.61(1.79~3.78)a 2.60(1.74~3.85)a 注：aP < 0.001; bP < 0.01; cP < 0.1; dP < 0.05; ORu：单因素分析OR(Odds Ratio)值；ORm：多因素分析OR值。 
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