广州市青年男男性行为者儿童期性虐待经历对抑郁的影响

  目的  了解广州市青年男男性行为者(young men who have sex with men，YMSM)儿童期性虐待(childhood sexual abuse，CSA)经历和抑郁症状的情况，探讨儿童期性虐待对抑郁的影响。  方法  采用方便抽样的方法，在广州市招募在广州居住时间≥3个月，年龄18~24周岁的365名YMSM作为研究对象，通过电子问卷收集调查对象的人口学特征、寻找性伴方式、性取向、CSA经历和抑郁症状等信息。采用χ2检验比较不同特征YMSM的CSA经历和抑郁情况，采用多因素Logistic回归模型分析CSA经历对抑郁的影响。  结果  YMSM中CSA经历和抑郁症状报告率分别为31.51%(115/365)和47.95%(175/365)。初中及以下文化程度(75.00%)以及通过线下寻伴方式(62.22%)的YMSM抑郁症状报告率较高(χ2值分别为7.97，4.19，P值均 < 0.05)。调整了民族、户籍所在地、居住时间、学生、文化程度、个人月收入、性取向、寻伴方式等因素后，多因素Logistic回归模型显示有CSA经历(aOR=1.81，95%CI=1.12~2.93)的YMSM有抑郁症状的可能性高于无CSA经历者。  结论  广州市YMSM有CSA经历和抑郁症状的比例较高，CSA经历是抑郁症状的危险因素。应注重加强对YMSM的心理干预，尤其是有CSA经历的YMSM，从而减少抑郁症状的比例，提高该人群心理健康水平。

Impact of childhood sexual abuse on depression among young men who have sex with men in Guangzhou

  Objective  To investigate the experience of child sexual abuse (CSA) and depressive symptoms among young men who sex with men (YMSM) in Guangzhou, and then to explore the impact of CSA on depressive symptoms.  Methods  A convenient sampling method was used to recruit MSM. YMSM who aged 18-24 and have lived in Guangzhou for more than 3 months were included in this study. Data on demographic characteristics, homosexual partners seeking behaviors, sexual orientation, CSA experience and depression were collected through an electronic questionnaire. χ2 tests were used to compare the proportion of CSA and depressive symptoms among YMSM with different characteristics. Logistic regressions were preformed to assess the impact of CSA on depression.  Results  The proportion of CSA experience and depressive symptoms among participants were 31.51% (115/365) and 47.95% (175/365), respectively. Participants with junior high school education or lower and who sought homosexual partners offline reported(75.00%, 62.22%) a higher proportion of depressive symptoms(χ2=7.97, 4.19, P < 0.05). After adjusting for factors e.g. ethnicity, residence, resident duration in Guangzhou, studentship, education, monthly income, sexual orientation and homosexual partners seeking behaviors, the multivariable Logistic regression model showed that YMSM with CSA experience (aOR=1.81, 95%CI=1.12-2.93) were more likely to have depressive symptoms than those without CSA experience.  Conclusion  The prevalence of CSA experience and depressive symptom is relatively high among YMSM in Guangzhou, and CSA experience is associated with higher risk of depressive symptoms. More attention should be paid to strengthen the psychological intervention for YMSM, especially for those who experienced CSA, so as to reduce the risk of depression and improve mental health among YMSM.