创伤后应激障碍与老年男男性行为者中酒精滥用和吸烟的关系：运动或志愿服务的影响没有证据。
The Relationship Between Posttraumatic Stress Disorder and Alcohol Misuse and Smoking Among Aging Men Who Have Sex With Men: No Evidence of Exercise or Volunteering Impact.
机构信息
Department of Epidemiology, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA.
Department of Family and Community Health, University of Pennsylvania School of Nursing, Philadelphia, PA, USA.
出版信息
J Aging Health. 2024 Dec;36(10):700-718. doi: 10.1177/08982643231215475. Epub 2023 Nov 17.
OBJECTIVES
To determine if the association between posttraumatic stress disorder (PTSD) and substance use (alcohol misuse or smoking tobacco) is mediated/moderated by exercise or volunteering among aging (≥40 years) men who have sex with men (MSM), and if this mediation/moderation differs by HIV serostatus.
METHODS
Multicenter AIDS Cohort Study data were used. Three datasets with PTSD measured during different time periods (10/1/2017-3/31/2018, 898 men; 4/1/2018-9/30/2018, 890 men; 10/1/2018-3/31/2019, 895 men) were analyzed. Longitudinal mediation analyses estimated the mediation effect of exercise and volunteering on the outcomes.
RESULTS
Nine percent of MSM had evidence of PTSD. There was no statistically significant mediation effect of exercise or volunteering regardless of substance use outcome. The odds of smoking at a future visit among MSM with PTSD were approximately double those of MSM without PTSD. Results did not differ by HIV serostatus.
DISCUSSION
There is a particular need for effective smoking cessation interventions for aging MSM with PTSD.
目的
确定在与男性性行为者（MSM）年龄≥40 岁的人群中，创伤后应激障碍（PTSD）与物质使用（酒精滥用或吸烟）之间的关联是否通过运动或志愿服务来调节/中介，以及这种调节/中介是否因 HIV 血清阳性状态而异。
方法
使用多中心艾滋病队列研究数据。分析了三个在不同时间段测量 PTSD 的数据集（2017 年 10 月 1 日至 2018 年 3 月 31 日，898 名男性；2018 年 4 月 1 日至 2018 年 9 月 30 日，890 名男性；2018 年 10 月 1 日至 2019 年 3 月 31 日，895 名男性）。纵向中介分析估计了运动和志愿服务对结果的中介效应。
结果
9%的 MSM 有 PTSD 的证据。无论物质使用结果如何，运动或志愿服务都没有统计学上显著的中介效应。有 PTSD 的 MSM 在未来就诊时吸烟的可能性大约是没有 PTSD 的 MSM 的两倍。结果不因 HIV 血清阳性状态而异。
讨论
对于患有 PTSD 的老年 MSM，特别需要有效的戒烟干预措施。
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