性少数青年男性的心理社会健康差异综合征及与自杀未遂风险的关联。
A syndemic of psychosocial health disparities and associations with risk for attempting suicide among young sexual minority men.
机构信息
Brian Mustanski and Rebecca Andrews are with the Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL. Amy Herrick and Ron Stall are with the University of Pittsburgh School of Public Health, Pittsburgh, PA. Phillip W. Schnarrs is with the University of Texas, San Antonio.
出版信息
Am J Public Health. 2014 Feb;104(2):287-94. doi: 10.2105/AJPH.2013.301744. Epub 2013 Dec 12.
OBJECTIVES
We examined a syndemic of psychosocial health issues among young men who have sex with men (MSM), with men and women (MSMW), and with women (MSW). We examined hypothesized drivers of syndemic production and effects on suicide attempts.
METHODS
Using a pooled data set of 2005 and 2007 Youth Risk Behavior Surveys from 11 jurisdictions, we used structural equation modeling to model a latent syndemic factor of depression symptoms, substance use, risky sex, and intimate partner violence. Multigroup models examined relations between victimization and bullying experiences, syndemic health issues, and serious suicide attempts.
RESULTS
We found experiences of victimization to increase syndemic burden among all male youths, especially MSMW and MSM compared with MSW (variance explained = 44%, 38%, and 10%, respectively). The syndemic factor was shown to increase the odds of reporting a serious suicide attempt, particularly for MSM (odds ratio [OR] = 5.75; 95% confidence interval [CI] = 1.36, 24.39; P < .001) and MSMW (OR = 5.08; 95% CI = 2.14, 12.28; P < .001) compared with MSW (OR = 3.47; 95% CI = 2.50, 4.83; P < .001).
CONCLUSIONS
Interventions addressing multiple psychosocial health outcomes should be developed and tested to better meet the needs of young MSM and MSMW.
目的
我们研究了男男性行为者（MSM）、男女皆有性行为者（MSMW）和女男性行为者（MSW）中的心理社会健康问题综合征。我们研究了假设的综合征产生驱动因素及其对自杀企图的影响。
方法
我们使用来自 11 个司法管辖区的 2005 年和 2007 年青年风险行为调查的汇总数据集，使用结构方程模型来构建抑郁症状、物质使用、高危性行为和亲密伴侣暴力的潜在综合征因素模型。多组模型检验了受害和欺凌经历、综合征健康问题与严重自杀企图之间的关系。
结果
我们发现，受害经历会增加所有男性青少年的综合征负担，尤其是 MSMW 和 MSM 比 MSW 更甚（方差解释分别为 44%、38%和 10%）。研究表明，综合征因素会增加报告严重自杀企图的几率，尤其是对 MSM（比值比 [OR] = 5.75；95%置信区间 [CI] = 1.36, 24.39；P < 0.001）和 MSMW（OR = 5.08；95% CI = 2.14, 12.28；P < 0.001），而 MSW 则不然（OR = 3.47；95% CI = 2.50, 4.83；P < 0.001）。
结论
应制定和测试针对多种心理社会健康结果的干预措施，以更好地满足年轻 MSM 和 MSMW 的需求。
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