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男男性行为者在三个西非国家的自杀意念:与耻辱感和社会资本的关联。

Suicidal ideation among MSM in three West African countries: Associations with stigma and social capital.

机构信息

Center for Public Health and Human Rights and Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA

Center for Public Health and Human Rights and Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.

出版信息

Int J Soc Psychiatry. 2016 Sep;62(6):522-31. doi: 10.1177/0020764016663969. Epub 2016 Aug 11.

Abstract

BACKGROUND

Suicidal ideation is understudied among men who have sex with men (MSM) across Sub-Saharan Africa.

AIMS

This study aimed to explore social capital and sexual behavior stigma associated with suicidal ideation among MSM in the West African nations of The Gambia, Burkina Faso and Togo.

METHODS

Participants were recruited using respondent-driven sampling and snowball sampling across multiple cities (n = 1555) from July 2011 to August 2013. During a single study visit, participants completed a survey. Logistic regression models were used to assess bivariate and multivariable associations with suicidal ideation.

RESULTS

The prevalence of lifetime suicidal ideation was 13% overall and ranged 6%-17% across study sites. After adjusting for potential confounders, MSM who reported stigma as a result of having sex with men were more likely to report suicidal ideation. Physical and sexual violence was strongly associated with suicidal ideation, including being physically harmed (adjusted odds ratio (aOR) = 2.94, 95% confidence interval (CI) = 1.91, 4.52), tortured (aOR = 3.86, 95% CI = 2.17, 6.86) and raped (aOR = 3.07, 95% CI = 2.05, 4.60). In contrast, increasing social participation with the broader community was associated with decreased report of suicidal ideation (aOR = 0.91, 95% CI = 0.85, 0.99).

CONCLUSION

Sexual behavior stigma should be addressed to improve mental health among MSM in Western Sub-Saharan Africa.

摘要

背景

在撒哈拉以南非洲,男男性行为者(MSM)中的自杀意念研究较少。

目的

本研究旨在探索与西非冈比亚、布基纳法索和多哥的 MSM 自杀意念相关的社会资本和性行为污名。

方法

2011 年 7 月至 2013 年 8 月,采用受访者驱动抽样和滚雪球抽样在多个城市招募参与者(n=1555)。在一次研究访问中,参与者完成了一项调查。使用逻辑回归模型评估与自杀意念的双变量和多变量关联。

结果

总体上,终身自杀意念的患病率为 13%,在研究地点的范围内为 6%-17%。在调整潜在混杂因素后,报告因与男性发生性关系而感到污名的 MSM 更有可能报告自杀意念。身体和性暴力与自杀意念密切相关,包括身体受到伤害(调整后的优势比(aOR)=2.94,95%置信区间(CI)=1.91,4.52)、被折磨(aOR=3.86,95%CI=2.17,6.86)和被强奸(aOR=3.07,95%CI=2.05,4.60)。相比之下,与更广泛的社区增加社会参与度与自杀意念报告减少相关(aOR=0.91,95%CI=0.85,0.99)。

结论

应该解决性行为污名问题,以改善西非撒哈拉以南地区 MSM 的心理健康。

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