HIV/AIDS病人自杀现状及影响因素的性别差异

Suicidal status and related factors between male and female people living with HIV/AIDS

目的 了解艾滋病病毒（HIV）感染者/艾滋病（AIDS）病人（简称HIV/AIDS病人）自杀现状,并分析其影响因素,探讨HIV/AIDS病人自杀影响因素的性别差异。方法 采用方便抽样的方法,于2013年3-6月对408例HIV/AIDS病人进行面对面问卷调查。采用Logistic回归分析自杀的影响因素。结果 自杀的定义为认真考虑过自杀或有过自杀行为,将两者合并为一类作为结局变量。调查对象中有过自杀的占32.8%（134/408）,男性高于女性,分别为35.9%（102/284）和25.8%（32/124）。多因素Logistic回归分析结果显示：男性中,处于抑郁状态[比值比（OR）=2.020,95%可信区间（CI）：1.131～3.606]、较高的耻辱感（OR=1.068,95%CI：1.033～1.104）、吸毒（OR=3.730,95%CI：1.303～10.69）为自杀的危险因素。女性中,处于抑郁状态（OR=8.320,95%CI：2.960～23.542）为危险因素,心理弹性水平高（OR=0.930,95%CI：0.872～0.998）为保护因素。结论 广州市HIV/AIDS病人中有过自杀的比例较高,且男性自杀比例高于女性。影响自杀的主要因素为耻辱感、性取向和抑郁状态。按照性别分层后,男/女性自杀意念或行为的因素不完全相同,故应针对不同性别的HIV/AIDS病人的影响因素实施进一步的干预。

Objective To explore the suicide status and related factors in different genders of PLWHA（people living with HIV/AIDS）. Methods Convenient sampling was adopted and 408 PLWHA were recruited in Guang- zhou from March to June in 2013. A self-designed questionnaire was used in this face-to-face survey. PLWHA who had suicidal ideation and suicidal attempt since being aware of their H1V infection was considered to be suicidal. Multivariate unconditional logistic regression was performed to identify factors associated with suicidal ideation and suicidal attempt. Results 32.8% （134/408） had suicidal ideation or attempt among the total 408 participants. The rate of suicide among male （35.9 %） was higher than female （25.8 %） , P〈0.05. Multivariate logistic regression indicated that risk factors for suicide among male PLWHA were depression（OR = 2. 020,95 % CI： 1. 131-3. 606）, perceived stigma（OR= 1. 068,95%CI：1. 033-1. 104） ,and drug use（OR= 3. 730,95%CI：1. 303-10.69）. Whereas a- mong female, depression（OR= 8. 320,95%CI：2. 960-23. 542） and high level of resilience（OR= 0. 930, 95%CI： 0. 872- 0. 998） were significantly associated with suicide. Conclusion Both genders had high suicidal rates, with-male PLWHA higher than female. Depression is a common risk factor for both genders. It is necessary to have targeted interventions to improve the mental health of PLWHA and tailored interventions may be more effective.