北京市MSM人群的心理健康影响因素

目的了解北京市男男性行为人群（MSM）心理健康状态,以及包括梅毒疾病感知及性行为等因素对其影响。方法采用滚雪球抽样方法。使用根据健康人疾病感知问卷（IPQ-RH）翻译并修订的问卷测量被访者对梅毒的疾病感知,采用CES-D-10和GAD-7量表测量被访者的抑郁和焦虑症状。结果 45.7%的被访者存在抑郁状态;34.4%出现不同程度的焦虑;9.5%在过去1周内曾有过自杀念头。梅毒疾病感知问卷中的时间延续-慢性、时间延续-周期性、严重后果和情感陈述4个维度的得分与CES-D-10及GAD-7量表的得分呈显著正相关。在Logistic回归分析中,MSM存在抑郁症状与其在北京居住时间超过2年和过去3个月中与男性发生过无保护肛交有关联;认为梅毒症状具有周期性、梅毒感染造成严重后果的MSM更易出现焦虑。结论北京市MSM的心理健康状况不容乐观,梅毒的疾病感知对未感染梅毒的MSM心理健康显著相关,梅毒有可能作为MSM干预项目新的出发点。

Mental health status of MSM in Beijing

Objective To investigate the mental health status of men who have sex with men（MSM） who were at high risk of syphilis infection in Beijing and the relationship between the lay illness perception of syphilis and the mental health. Methods MSM were recruited by snowball sampling in Beijing. A translated and revised version of illness perception questionnaire for the healthy individuals（IPQ-RH） was used to investigate their perception of syphilis. Depression and anxiety were measured by CES-D-10 and GAD-7, respectively. Results The prevalence of symptoms of depression and anxiety was 45.7% and 34.4%, respectively. 9.5% of the respondents had suicidal ideation in the last week. The scores of timeline （chronic）, timeline （cyclical）, consequence and emotional representation were positively associated with the score of CES-D-10 and GAD-7. In a stepwise logistic regression model, those who were living in Beijing for over 2 years （OR=0.10） and had unprotected anal intercourse with men in the past 3 months（OR=3.79）were significantly associated with symptoms of depression （P〈0.05）. MSM who had higher score in timeline （cyclical） （OR= 1.18） and consequence （OR= 1.18） were more likely to develop symptoms of anxiety （P〈0.05）. Conclusion The mental health status of MSM in Beijing is still far from being optimistic. Lay illness perception of syphilis among uninfected MSM is significantly associated with their mental health status. Syphilis might serve as a new entry point for future intervention program among MSM in China.