Institute for Global Health, University College London, London, UK.
56 Dean Street, London, UK.
AIDS Behav. 2020 Jun;24(6):1793-1806. doi: 10.1007/s10461-019-02724-0.
The aim of this study is to investigate five hypothesized mechanisms of causation between depression and condomless sex with ≥ 2 partners (CLS2+) among gay, bisexual, and other men who have sex with men (GBMSM), involving alternative roles of self-efficacy for sexual safety and recreational drug use. Data were from the AURAH cross-sectional study of 1340 GBMSM attending genitourinary medicine clinics in England (2013-2014). Structural equation modelling (SEM) was used to investigate which conceptual model was more consistent with the data. Twelve percent of men reported depression (PHQ-9 ≥ 10) and 32% reported CLS2+ in the past 3 months. AURAH data were more consistent with the model in which depression was considered to lead to CLS2+ indirectly via low self-efficacy for sexual safety (indirect Beta = 0.158; p < 0.001) as well as indirectly via higher levels of recreational drug use (indirect Beta = 0.158; p < 0.001). SEM assists in understanding the relationship between depression and CLS among GBMSM.
本研究旨在探究五种假设的因果机制，即抑郁症与≥2 名性伴侣发生无保护性行为（CLS2+）之间的关系，涉及性安全自我效能感和娱乐性药物使用的替代作用，研究对象为男同性恋、双性恋和其他男男性行为者（GBMSM）。数据来自于 2013-2014 年在英国泌尿科医学诊所就诊的 1340 名 GBMSM 的 AURAH 横断面研究。结构方程模型（SEM）用于调查哪个概念模型与数据更一致。12%的男性报告患有抑郁症（PHQ-9≥10），32%的男性报告在过去 3 个月内有 CLS2+。AURAH 数据与抑郁症通过性安全自我效能感降低间接导致 CLS2+（间接 Beta=0.158；p<0.001）以及通过娱乐性药物使用增加间接导致 CLS2+的模型更为一致（间接 Beta=0.158；p<0.001）。SEM 有助于理解 GBMSM 中抑郁症与 CLS 之间的关系。
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