广州市HIV感染者/AIDS患者抑郁影响因素的性别差异

Gender differences in factors associated with depression among people living with HIV/AIDS in Guangzhou

目的探讨广州市不同性别的HIV感染者/AIDS患者抑郁影响因素的性别差异。方法通过方便抽样的方法,于2013年3—5月,采用自行设计的调查问卷对广州市第八人民医院的HIV感染者/AIDS患者进行问卷调查。主要包括一般人口社会学特征、HIV感染相关因素、抑郁状况、社会支持和自我效能状况、HIV相关羞辱和歧视感等。对调查结果进行描述性分析,并采用单、多因素分析方法对调查对象的抑郁状况及其影响因素进行分析。结果本研究共调查409例HIV感染者/AIDS患者,调查对象中男性占69.9%(286/409),女性占30.1%(123/409);平均年龄为(36.26±8.82)岁。男性调查对象抑郁平均得分为(16.13±10.97)分,抑郁发生率为49.0%(140/286);女性调查对象抑郁平均得分为(16.15±12.71)分,抑郁发生率为46.3%(57/123),两者差异无统计学意义(P>0.05)。多因素logistic分析结果显示,自我效能得分(OR=0.232)、HIV相关羞辱和歧视感得分(OR=3.082)和性别与社会支持的交互作用(OR=0.663)是HIV感染者/AIDS患者抑郁的影响因素。相比较于获得较高社会支持的男性感染者,获得较高社会支持的女性感染者其发生抑郁的风险更低(OR=0.663)。基于性别的分层分析结果显示,对于男性感染者来说,较高的HIV相关羞辱和歧视感得分(OR=3.102)会增加抑郁的风险,而较高的自我效能得分(OR=0.176)可降低抑郁的风险。对于女性感染者而言,较高的HIV相关羞辱和歧视感得分(OR=4.309)会显著增加抑郁的风险,而有外出打工经历(OR=0.363)和较高的社会支持(OR=0.333)则降低抑郁的风险。结论广州市HIV感染者/AIDS患者抑郁状况较为严重。除了HIV相关羞辱和歧视感外,影响HIV感染者/AIDS患者抑郁状况的因素具有性别差异,男性感染者主要受到自我效能的影响,女性感染者主要受到社会支持的影响。

Objective To explore depression and its influencing factors among people living with HIV / AIDS（ PLWHA） with different genders in Guangzhou. Methods PLWHA in Guangzhou No. 8 Hospital were recruited using convenient sampling method from March to May 2013 and interviewed using a self-designed questionnaire that included questions about socio-demographic characteristics,HIV infection related factors,depression,social support and self efficacy,and HIV / AIDS related stigma and discrimination. Chi-square test and multivariate unconditional logistic regression were used to analyze depression status and its influencing factors. Results A total of 409 PLWHA were included in this study,including 286males（ 69. 9%） and 123 females（ 30. 1%）,and the average age was（ 36. 26 ± 8. 82） years. The average scores of depression were（ 16. 13 ± 10. 97） in male PLWHA and（ 16. 15 ± 12. 71） in female. The prevalence of depression was 49. 0%（ 140 /286） in male and 46. 3%（ 57 /123） in female（ P〈0. 05）.Multivariate logistic regression analysis indicated that self-efficacy（ OR： 0. 232）,HIV-related stigma（ OR： 3. 082） and interaction between gender and social support（ OR： 0. 663） were significantly associated with depression. In a gender-stratified analysis,HIV-related stigma（ OR： 3. 102） and level of self-efficacy（ OR： 0. 176） were associated with depression among male PLWHA,whereas HIV-related stigma（ OR： 4. 309）,level of social support（ OR： 0. 333） and work experience outside hometown（ OR： 0. 363）were associated with depression among female PLWHA. Conclusion The prevalence of depression among PLWHA in Guangzhou was relatively high compared with the national average level among the general population. Besides HIV-related stigma,important influencing factors of depression among PLWHA were selfefficacy for male and social support for female.