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俄亥俄州陆军国民警卫队士兵的创伤后应激障碍、抑郁和 HIV 风险行为。

Posttraumatic stress disorder, depression, and HIV risk behavior among Ohio Army National Guard Soldiers.

机构信息

Department of Epidemiology, Columbia University Mailman School of Public Health, New York, New York, USA.

出版信息

J Trauma Stress. 2013 Feb;26(1):64-70. doi: 10.1002/jts.21777.

Abstract

We examined the relationship between posttraumatic stress disorder (PTSD), major depressive disorder (MDD), and human immunodeficiency virus (HIV) risk behavior among the Ohio Army National Guard (OHARNG). We analyzed data collected from a sample of OHARNG enlisted between June 2008 and February 2009. Participants completed interviews assessing HIV risk activities defined by the Behavioral Risk Factor Surveillance System, and were screened for PTSD and MDD based on DSM-IV criteria according to the Diagnostic and Statistical Manual of Mental Disorders (4th ed., DSM-IV; American Psychiatric Association, 1994). Logistic regression was used to examine the independent and combined effects of PTSD and MDD on past-year HIV risk behavior. Of 2,259 participants, 142 (6.3%) reported at least 1 past-year HIV risk behavior. In adjusted models, relative to soldiers with neither disorder, screening positive for MDD only was associated with HIV risk behavior (adjusted odds ratio [AOR] = 2.33, 95% CI = [1.15, 4.71]), whereas PTSD was not significant (AOR = 1.60, 95% CI = [0.80, 3.20]). Participants with both PTSD and depression were most likely to report HIV risk behavior (AOR = 2.75, 95% CI = [1.06, 7.11]). Soldiers with PTSD and MDD may be at greater risk for HIV infection due to increased engagement in HIV risk behavior. Integrated interventions to address mental health problems and reduce HIV risk behavior are in need of development and evaluation.

摘要

我们研究了创伤后应激障碍(PTSD)、重度抑郁障碍(MDD)与俄亥俄州国民警卫队(OHARNG)艾滋病毒(HIV)风险行为之间的关系。我们分析了 2008 年 6 月至 2009 年 2 月间招募的 OHARNG 士兵样本数据。参与者根据行为风险因素监测系统完成了有关 HIV 风险行为的访谈,并根据《精神障碍诊断与统计手册》(第四版,DSM-IV;美国精神病学协会,1994 年)的 DSM-IV 标准进行了 PTSD 和 MDD 筛查。使用逻辑回归检验 PTSD 和 MDD 对过去一年 HIV 风险行为的独立和综合影响。在 2259 名参与者中,有 142 名(6.3%)报告了至少 1 种过去一年的 HIV 风险行为。在调整模型中,与没有任何一种疾病的士兵相比,仅 MDD 阳性与 HIV 风险行为相关(调整后的优势比 [AOR] = 2.33,95%置信区间 [CI] = [1.15, 4.71]),而 PTSD 不显著(AOR = 1.60,95% CI = [0.80, 3.20])。同时患有 PTSD 和抑郁症的参与者最有可能报告 HIV 风险行为(AOR = 2.75,95% CI = [1.06, 7.11])。患有 PTSD 和 MDD 的士兵可能由于更多地参与 HIV 风险行为而面临更大的 HIV 感染风险。需要开发和评估针对心理健康问题并减少 HIV 风险行为的综合干预措施。

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