HIV感染者和AIDS病人自杀意念现状及其影响因素研究

Suicidal ideation and influencing factors among people living with HIV/AIDS

目的了解HIV感染者和AIDS病人（PeopleLivingwithHIV／AIDS，PLWHA）自杀意念现状，探讨其影响因素，为制定关怀干预对策提供客观依据。方法采用《自杀意念自评量表》（SIOSS）和评价方法，以2012年5月至2012年12月在广州市番禺区CDC艾滋病VCT门诊就诊的PLWHA为调查对象，进行面对面问卷调查，调查其人口学特征及对其是否持有自杀意念进行评价。采用多因素logistic回归分析对PLWHA的自杀影响因素进行统计学析。结果在调查的144例PLWHA中，男性占67．36％（97／144），女性占32．64％（47／144）；平均年龄（36．9±10．8）岁。29．17％（42／144）患者有自杀意念。在自杀意念发生率方面，无业／待业者为（50．00％，9／18）高于有工作者（26．29％，33／126）、中专／高中及以下者为（32．52％，40／123）高于大专及以上者（9．52％，2／21）、独居者为（58．33％，7／12）高于非独居者（26．52％，35／132）、CD。细胞计数~〈200cells／μL者为（47．83％，11／23）高于〉200cells／μL者（25．62％，31／121），差异均有统计学意义（均P〈0．05）。多因素logistic回归分析结果显示就业状况和居住方式为产生自杀意念的危险因素，其调整的OR值和95％CI分别为：4．813（1．250—18．526）和8．832（1．330～58．661）。结论PLwHA普遍存在自杀意念，应在随访关怀过程中，建立有效的综合支持体系，以改善PLWHA心理状况。

Objective To explore suicidal ideation and its relevant factors in people living with HIV/AIDS （PLWHA） and provide the basis for making AIDS care intervention countermeasure. Methods General condition questionnaire and Self-rating Idea of Suicide Scale （SIOSS） were used in the survey. Face to face survey was conducted in PLWHA at AIDS VCT clinics, Panyu District, Guangzhou City. Mul- tiple linear regression was used to analyze the data. Results Of 144 cases of PLWHA in the survey, 67.36% （97/144） were male, 32. 64% （47/144） were female, and the average age was（36. 9 ± 10. 8） years （mean± SD）. 29. 17% （42/144）have suicidal ideation. The rate of suicidal ideation was higher in those without job/unemployed （ 50. 00% , 9/18 ） than those with job （ 26. 29% , 33/126 ）, higher in those with technical/secondary school/high school（32. 52% ,40/123 ） than those with college degree or above （9.52%, 2/21 ）, higher in persons living alone （58.33%, 7/12） than persons living with family （26. 52%, 35/132）, higher in those with the CD4 cell count ≤200 eells/μL （47.83%, 11/23） than those with the CD4 cell count 〉 200 cells/μL （25.62% , 31/121 ） , all P 〈 0. 05. Multivariate logistic re- gression showed that the employment status （ adjusted OR：4. 813, 95% CI： 1. 250 - 18. 526） and the resi-dent manner （OR： 8. 832, 95% CI： 1. 330 -58. 661 ） were associated with the risk of suicidal ideation. Conclusion The prevalence of suicidal ideation was widespread among PLWHA. In the course of the fol- low-up care, effective and comprehensive support system should be established to improve the psychological status of PLWHA.