Gielen Andrea Carlson, McDonnell Karen A, O'Campo Patricia J, Burke Jessica Griffin
Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA.
Womens Health Issues. 2005 Mar-Apr;15(2):89-95. doi: 10.1016/j.whi.2004.12.004.
This study examines the association between women's HIV serostatus, intimate partner violence (IPV) experience, and risk of suicide and other mental health indicators. Using data from Project WAVE (Women, AIDS, and the Violence Epidemic), we 1) describe the rates of suicidal thoughts and attempts, anxiety, and depression; 2) examine whether and to what extent these outcomes differ by women's HIV and IPV status.
A one-time interview was conducted with a sample 611 women living in an urban area, one-half of whom were HIV-positive.
Having thought about suicide was reported by 31% of the sample and 16% reported having attempted suicide. Among HIV-positive women, thoughts of suicide occurred more frequently among those who were recently diagnosed. One-half of the sample reported problems with depression, and 26% reported problems with anxiety; of women reporting these problems, 56% received mental health treatment. Rates varied significantly by HIV and IPV status, with women who were both HIV-positive and abused consistently faring worse. Relative to HIV-negative non-abused women, HIV-positive abused women were 7.0 times as likely to report problems with depression, 4.9 times as likely to report problems with anxiety, 3.6 times as likely to have thought about suicide, and 12.5 times as likely to have ever attempted suicide. Our findings that abused HIV-negative women were also at significantly elevated risk for all of these outcomes lends support to the conclusion that it is the experience of abuse that is associated with the negative outcomes.
Health care and service providers interacting with women who may be HIV-positive and/or in abusive relationships should routinely assess for mental health status, especially suicide risk, which may need crisis intervention.
本研究探讨女性的艾滋病毒血清学状态、亲密伴侣暴力(IPV)经历与自杀风险及其他心理健康指标之间的关联。利用“WAVE项目”(妇女、艾滋病与暴力流行)的数据,我们:1)描述自杀念头和自杀未遂、焦虑和抑郁的发生率;2)研究这些结果在感染艾滋病毒和遭受亲密伴侣暴力的女性中是否存在差异以及差异程度。
对居住在城市地区的611名女性进行了一次性访谈,其中一半为艾滋病毒阳性。
31%的样本报告有过自杀念头,16%报告有过自杀未遂。在艾滋病毒阳性女性中,近期确诊的女性自杀念头出现得更为频繁。一半的样本报告有抑郁问题,26%报告有焦虑问题;报告有这些问题的女性中,56%接受了心理健康治疗。这些发生率因艾滋病毒和亲密伴侣暴力状态的不同而有显著差异,艾滋病毒阳性且遭受虐待的女性情况始终更糟。与艾滋病毒阴性且未遭受虐待的女性相比,艾滋病毒阳性且遭受虐待的女性报告抑郁问题的可能性高7.0倍,报告焦虑问题的可能性高4.9倍,有自杀念头的可能性高3.6倍,有过自杀未遂的可能性高12.5倍。我们发现,遭受虐待的艾滋病毒阴性女性在所有这些结果方面的风险也显著升高,这支持了以下结论:与负面结果相关的是虐待经历。
与可能感染艾滋病毒和/或处于虐待关系中的女性打交道的医疗保健和服务提供者应常规评估其心理健康状况,尤其是自杀风险,这可能需要进行危机干预。