Medical Research Council (MRC) Clinical Trials Unit at University College London (UCL), 90 High Holborn, WC1V 6LJ, London, UK.
Imperial College Healthcare NHS Trust, London, UK.
BMC Public Health. 2019 Aug 27;19(1):1165. doi: 10.1186/s12889-019-7424-7.
Self-harm in adolescents is of growing concern internationally but limited evidence exists on the prevalence of self-harm in those living with HIV, who may be at higher risk of poor mental health outcomes. Therefore our aim was to determine the prevalence and predictors of self-harm among young people with perinatally-acquired HIV (PHIV) and HIV negative (with sibling or mother living with HIV) young people living in England.
303 PHIV and 100 HIV negative young people (aged 12-23 years) participating in the Adolescents and Adults Living with Perinatal HIV cohort study completed an anonymous self-harm questionnaire, as well as a number of standardised mental-health assessments. Logistic regression investigated predictors of self-harm.
The median age was 16.7 years in both groups, and 40.9% of the PHIV and 31.0% of the HIV negative groups were male. In total 13.9% (56/403) reported having ever self-harmed, with no difference by HIV status (p = 0.089). Multivariable predictors of self-harm were female sex (adjusted odds ratio (AOR) 5.3, (95% confidence interval 1.9, 14.1), p = 0.001), lower self-esteem (AOR 0.9 (0.8, 0.9) per 1 point increase, p < 0.001) and having ever used alcohol (AOR 3.8 (1.8, 7.8), p < 0.001). Self-esteem z-scores for both PHIV and HIV negative participants were 1.9 standard deviations below the mean for population norms.
Self-harm is common among PHIV and HIV negative adolescents in England. Reassuringly however, they do not appear to be at an increased risk compared to the general adolescent population (15-19% lifetime prevalence). The low level of self-esteem (compared to available normative data) in both groups is worrying and warrants further attention.
青少年自残行为在国际上受到越来越多的关注，但在感染艾滋病毒的青少年中，自残行为的流行程度有限，他们可能面临更差的心理健康结局的风险。因此，我们的目的是确定在英国感染艾滋病毒的青少年（PHIV）和艾滋病毒阴性（与感染艾滋病毒的兄弟姐妹或母亲生活在一起）青少年中，自残行为的流行率和预测因素。
303 名 PHIV 和 100 名 HIV 阴性的年轻人（年龄在 12-23 岁之间）参与了“青少年和成年人感染围产期 HIV 队列研究”，完成了一份匿名的自我伤害问卷，以及一些标准化的心理健康评估。逻辑回归调查了自我伤害的预测因素。
两组的中位年龄均为 16.7 岁，PHIV 组和 HIV 阴性组的男性分别占 40.9%和 31.0%。共有 13.9%（56/403）的人报告曾有过自残行为，两组之间无差异（p=0.089）。自我伤害的多变量预测因素为女性（调整后的优势比（AOR）5.3，95%置信区间 1.9，14.1，p=0.001）、自尊心较低（每增加 1 分，AOR 0.9（0.8，0.9），p<0.001）和曾经使用过酒精（AOR 3.8（1.8，7.8），p<0.001）。PHIV 和 HIV 阴性参与者的自尊 z 分数均比人群平均值低 1.9 个标准差。
在英国，PHIV 和 HIV 阴性的青少年中，自残行为很常见。然而，令人欣慰的是，与一般青少年人群（终生患病率 15-19%）相比，他们似乎没有更高的风险。两组的自尊水平都很低（与可用的规范数据相比）令人担忧，需要进一步关注。
