School of Public Health, Kunming Medical University, Kunming, Yunnan, 650500, China.
School of Life science, Tsinghua University, Beijing, 100084, China.
BMC Public Health. 2024 Aug 19;24(1):2248. doi: 10.1186/s12889-024-19444-3.
The prevalence of self-injury and suicide is higher than the general population of people living with HIV/AIDS (PLWHA). However, the results reported in existing studies are highly variable in China. The purpose of this systematic review and meta-analysis was to synthesize the currently available high-quality evidence to explore the prevalence and influence factors of self-injury and suicide among PLWHA in China.
We retrieve literature written in Chinese and English through databases such as PubMed, Embase, Web of Science, Cochrane Library, SinoMed, CNKI, WanFang Database, and CQVIP from inception to 1 September 2022. Sata 16.0 software was used for analysis.
A total of 28 studies were included with a sample size of 1,433,971 and had a satisfactory quality score of ≥ 5. The prevalence among PLWHA in China were 30% for suicidal ideation (SI), 5% for suicide attempt (SA), 8% for suicide plan (SP), 7% for attempted suicide (AS), and 3‰ for completed suicide. High stigma (OR = 2.94, 95%CI: 1.90 - 4.57), depression (OR, 3.17; 95%CI, 2.20 - 4.57), anxiety (OR, 3.06; 95%CI, 2.23 - 4.20), low self-esteem (OR, 3.82, 95%CI, 2.22 - 6.57), high HIV related stress (OR, 2.53; 95%CI, 1.36 - 4.72), and unemployment (OR, 2.50; 95%CI, 1.51 - 4.15) are risk factors for SI; high social support (OR, 0.61; 95%CI, 0.44 - 0.84) and spouse infected with HIV (OR, 0.39; 95%CI, 0.21 - 0.74) are protective factors for SI; depression (OR, 1.62; 95%CI, 1.24 - 2.13), high aggression (OR, 4.66; 95%CI, 2.59 - 8.39), and more negative life events (OR, 2.51; 95%CI, 1.47 - 4.29) are risk factors for AS; high level of education (OR, 1.31; 95%CI, 1.21 - 1.43) is risk factor for CS.
Figures indicate that approximately one-third of PLWHA had suicidal ideation, and three out of 1,000 completed suicide in China. Positive events are protective factors for self-injury and suicide among PLWHA, while negative events are risk factors. This suggests that psychosocial support and risk assessment should be integrated into the care of PLWHA.
自我伤害和自杀的发生率高于一般的 HIV/AIDS 患者人群。然而，在中国，现有研究报告的结果差异很大。本系统评价和荟萃分析的目的是综合目前高质量的证据，以探讨中国 HIV/AIDS 患者自我伤害和自杀的发生率和影响因素。
我们通过 PubMed、Embase、Web of Science、Cochrane 图书馆、SinoMed、CNKI、WanFang Database 和 CQVIP 等数据库，检索了从成立到 2022 年 9 月 1 日发表的中、英文文献。使用 Stata 16.0 软件进行分析。
共纳入 28 项研究，样本量为 1433971 人，质量评分均≥5 分，质量较高。中国 HIV/AIDS 患者的自杀意念发生率为 30%，自杀未遂发生率为 5%，自杀计划发生率为 8%，自杀企图发生率为 7%，完成自杀发生率为 3‰。高耻辱感（OR=2.94，95%CI：1.90-4.57）、抑郁（OR，3.17；95%CI，2.20-4.57）、焦虑（OR，3.06；95%CI，2.23-4.20）、低自尊（OR，3.82，95%CI，2.22-6.57）、高 HIV 相关压力（OR，2.53；95%CI，1.36-4.72）和失业（OR，2.50；95%CI，1.51-4.15）是自杀意念的危险因素；高社会支持（OR，0.61；95%CI，0.44-0.84）和配偶感染 HIV（OR，0.39；95%CI，0.21-0.74）是自杀意念的保护因素；抑郁（OR，1.62；95%CI，1.24-2.13）、高攻击性（OR，4.66；95%CI，2.59-8.39）和更多的负性生活事件（OR，2.51；95%CI，1.47-4.29）是自杀企图的危险因素；高教育水平（OR，1.31；95%CI，1.21-1.43）是自杀的危险因素。
研究结果表明，中国约有三分之一的 HIV/AIDS 患者有自杀意念，每千名 HIV/AIDS 患者中就有 3 人完成自杀。积极的事件是 HIV/AIDS 患者自我伤害和自杀的保护因素，而消极的事件是危险因素。这表明，应该将心理社会支持和风险评估纳入 HIV/AIDS 患者的护理中。
