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男男性接触者焦虑与抑郁症状的相关性及其与艾滋病高危性行为的关系
胡珊1,钟晓妮1,陈江鹏1,文小焱1,付春静1,曾馨1,黄爱龙2,彭斌1*
0
(1. 重庆医科大学公共卫生与管理学院、医学与社会发展研究中心、健康领域社会风险预测治理协同创新中心, 重庆 400016;
2. 重庆医科大学感染性疾病分子生物学教育部重点实验室, 重庆 400016
*通信作者)
摘要:
目的 探讨男男性接触者(MSM)焦虑与抑郁症状的相关性,以及焦虑、抑郁、焦虑和抑郁共病与艾滋病相关行为特征的关系,为该人群的艾滋病行为干预提供依据。 方法 以非随机抽样方法招募研究对象,用焦虑自评量表(SAS)和流调中心抑郁量表(CES-D)对MSM进行焦虑和抑郁症状的评定。根据量表结果将研究对象分为焦虑组、抑郁组、共病组和焦虑抑郁阴性组,比较焦虑组、抑郁组和焦虑抑郁共病组艾滋病相关行为的差异,并通过典则相关分析焦虑组和抑郁组各症状的相关性。 结果 共调查了854名MSM,焦虑和抑郁的检出率分别为31.97%(273/854)和45.55%(389/854),焦虑抑郁共病者占27.28%(233/854)。差异分析结果显示焦虑、抑郁患病状况以及焦虑抑郁共病与户口、文化程度、性取向以及性病史这4个人口学特征相关(P<0.05);女性性伴数、最近6个月通过互联网寻找性伴的频率以及最近半年是否提供或得到商业性性服务这3个艾滋病相关行为特征与焦虑、抑郁患病状况以及焦虑抑郁共病相关(P<0.05)。焦虑和抑郁两组症状的典则相关分析表明,焦虑量表中的焦虑和恐慌(Y1)、身体控制(Y3)和肠胃相关感(Y4)与抑郁量表中的抑郁情绪(X1)和躯体症状(X3)正相关;焦虑量表中的前庭感觉(Y2)与抑郁量表中的积极情绪(X2)正相关,与文化程度(X6)负相关。 结论 MSM中,焦虑、抑郁问题普遍存在,焦虑症状与抑郁症状之间存在高度相关,其共病现象较严重,并与MSM的艾滋病相关行为特征关系密切。
关键词:  男男性接触者  焦虑  抑郁  共病现象  获得性免疫缺陷综合征
DOI:10.3724/SP.J.1008.2015.1247
投稿时间:2015-03-16修订日期:2015-05-27
基金项目:国家科技重大专项(2012ZX10001007-007).
Relationship between anxiety and depression symptoms and their associations with HIV high risk sexual behaviors among men who have sex with men (MSM)
HU Shan1,ZHONG Xiao-ni1,CHEN Jiang-peng1,WEN Xiao-yan1,FU Chun-jing1,ZENG Xin1,HUANG Ai-long2,PENG Bin1*
(1. School of Public Health and Management, Chongqing Medical University, Research Center for Medicine and Social Development, Innovation Center for Social Risk Governance in Health, Chongqing 400016, China;
2. The Key Laboratory of Education Ministry for Molecular Biology of Infectious Diseases, Chongqing Medical University, Chongqing 400016, China
*Corresponding author.)
Abstract:
Objective To study the relationship between anxiety and depression symptoms and the relationships of HIV related behaviors with anxiety, depression and their comorbidity among men who have sex with men(MSM), so as to provide evidence for HIV behavior intervention. Methods Nonrandom sampling was applied to recruit MSM. Self-Rating Anxiety Scale (SAS) and The Center for Epidemiological Studies Depression Scale (CES-D) were used to evaluate the anxiety and depression symptoms. The participants were divided into four groups according to the results: anxiety, depression, their comorbidity and negative groups. The differences in HIV related behaviors among the four groups were compared and the canonical correlation analysis was used to study the relationship between anxiety and depression symptoms. Results Totally 854 MSM were surveyed in the present study. The detection rate of anxiety was 31.97% (273/854) and that of depression was 45.55% (389/854). The positive rate of comorbid anxiety and depression was 27.28% (233/854). Variance analysis showed that anxiety, depression and their comorbidity were correlated with 4 demographic characteristics:registered residence, educational level, sexual orientation and history of sexually transmitted disease (STD) (P<0.05); three HIV related behaviors(number of female sexual partners, looking for partner via the internet in recent 6 months, and providing or getting commercial sex services in recent 6 months) were correlated with anxiety, depression and their comorbidity (P<0.05).The canonical correlation analysis showed that depressed affect(X1), somatic and retarded activity(X3) of depression had a positive impact on anxiety and panic(Y1), somatic control(Y3) and gastrointestinal sensations(Y4) of anxiety; positive affect (X2) had a positive impact on vestibular sensations(Y2), while education(X6) had a negative influence on it. Conclusion Anxiety and depression are common in MSM, and there is a close relation between anxiety and depression symptoms; comorbidity of anxiety and depression is common; and all of them are highly associated with HIV related behaviors.
Key words:  men who have sex with men  anxiety  depression  comorbidity  acquied immunodeficiency syndrome