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中国 HIV 阳性性少数男性人群自杀意念变化及其预测因素:一项为期五年的纵向研究。

The Changes and the Predictors of Suicidal Ideation Among HIV-positive Sexual Minority Men: A Five-year Longitudinal Study from China.

机构信息

Department of Social Medicine and Health Management, Xiangya School of Public Health, Central South University, 110 Xiangya Road, Changsha, Hunan, 410078, People's Republic of China.

Department of Urban-Global Public Health, Rutgers School of Public Health, Rutgers University, Newark, NJ, USA.

出版信息

AIDS Behav. 2022 Feb;26(2):339-349. doi: 10.1007/s10461-021-03387-6. Epub 2021 Jul 31.

Abstract

This study aimed to explore whether there were differences in suicidal ideation at different time points among sexual minority men (SMM) within five years of HIV diagnosis, and to investigate the influence of time and psychosocial variables on suicidal ideation. This was a five-year follow-up study focusing on the suicidal ideation among HIV-positive SMM who were recruited when they were newly diagnosed with HIV. Suicidal ideation and psychosocial characteristics including depression, anxiety, HIV-related stress, and social support were assessed within one month, the first year, and the fifth year after HIV diagnosis. A total of 197 SMM newly diagnosed with HIV completed three-time point surveys in this study. The prevalence of suicidal ideation was 27.4%, 15.7%, and 23.9% at one month, the first year, and the fifth year after HIV diagnosis, respectively. The risk of suicidal ideation was lower in the first year than baseline, but there was no significant difference between the fifth year and baseline. Emotional stress and objective support independently predicted suicidal ideation and they had interactions with time. The suicidal ideation of SMM newly diagnosed with HIV decreased in the first year and then increased in the fifth year, not showing a sustained decline trend in a longer trajectory of HIV diagnosis. Stress management, especially long-term stress assessment and management with a focus on emotional stress should be incorporated into HIV health care in an appropriate manner. In addition, social support should also be continuously provided to this vulnerable population.

摘要

本研究旨在探讨 HIV 诊断后五年内,性少数男性(SMM)在不同时间点的自杀意念是否存在差异,并探讨时间和心理社会变量对自杀意念的影响。这是一项五年随访研究,重点关注 HIV 阳性 SMM 在 HIV 初诊时的自杀意念。在 HIV 诊断后一个月、第一年和第五年评估自杀意念和心理社会特征,包括抑郁、焦虑、HIV 相关压力和社会支持。共有 197 名新诊断为 HIV 的 SMM 完成了这项研究的三次调查。在 HIV 诊断后一个月、第一年和第五年,自杀意念的发生率分别为 27.4%、15.7%和 23.9%。与基线相比,第一年自杀意念的风险较低,但第五年与基线相比没有显著差异。情感压力和客观支持独立预测自杀意念,且与时间存在交互作用。新诊断为 HIV 的 SMM 的自杀意念在第一年下降,然后在第五年上升,在 HIV 诊断的更长时间轨迹中没有表现出持续下降的趋势。应适当将压力管理纳入 HIV 保健中,特别是要对情感压力进行长期的压力评估和管理。此外,还应持续为这一弱势群体提供社会支持。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c471/8813835/0f6bffb77422/10461_2021_3387_Fig1_HTML.jpg

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