绵阳市年轻男男性行为者自杀意念及关联因素分析

Suicide ideation and its associated factors among young men who have sex with men in Mianyang City

目的了解年轻男男性行为者(YMSM)自杀意念现状,分析关联因素。方法以四川省绵阳市15～24周岁男男性行为者为对象,用滚雪球抽样法进行招募调查和血清学检测。关联因素单因素分析用χ2检验,多因素分析用非条件logistic回归。结果共合格调查350人,20. 0%产生过自杀意念,主要为情感因素占45. 7%; 6. 6%实施过自杀。是否有过自杀意念艾滋病病毒(HIV)感染率分别为14. 3%、7. 9%(χ~2=2. 753,P=0. 097)。多因素分析结果:经历性虐待(OR=8. 748)、因性取向受过伤害(OR=2. 529)、性取向自我态度负向(OR=3. 164)、公开性取向受到家人冷落(OR=22. 727)、近6个月商业性行为(OR=4. 630)是YMSM自杀意念的危险因素。结论 YMSM自杀意念发生率高,性虐待及社会、家庭和自我歧视影响明显,增大HIV感染潜在风险。减少歧视性环境和增强未成年人保护,是YMSM自杀危机干预的重要内容。

Objective To investigate the current status of suicide ideation among young men who have sex with men (YMSM), and to analyze the associated factors. Methods MSM aged 15-24 years in Mianyang City, Sichuan Province were recruited by the method of rolling snowball sampling, and then serological examination was performed. Single factors associated with suicide ideation were analyzed by χ^2 test, while multiple factors by unconditional logistic regression analysis. Results A total of 350 eligible subjects were investigated. 20.0% (70/350) of the subjects had suicide ideation, and 45.7% (32/70) suicide ideation was caused by emotional factors. 6.6% (23/350) committed suicide. The HIV infection rates of subjects with and without suicide ideation were 14.3% and 7.9% (χ^2=2.753, P=0.097) respectively. Multivariate analysis showed that having an experience of sexual abuse (OR=8.748), having been hurt due to sexual orientation (OR=2.529), having a negative attitude towards own sexual orientation (OR=3.164), having been snubbed by family members due to sexual orientation (OR=22.727) and having commercial sexual behavior in the last six months (OR=4.630) were the risk factors for suicide ideation in the YMSM. Conclusions The high incidence rate of suicide ideation and the obvious negative impacts of sexual abuse and social-, family- and self-discrimination in YMSM increase the potential risk of HIV infection. Reducing discriminatory environment and enhancing protection of minors are the important contents of suicide crisis intervention in YMSM.