AIDS患者感染结果告知、歧视知觉、社会支持与自杀意念的关系

目的  分析AIDS患者的歧视知觉和自杀意念，以及歧视知觉、自杀意念和HIV感染结果告知及社会支持之间的关系。方法  采用一般特征调查表、领悟社会支持量表(perceived social support scale, PSSS)、歧视知觉量表(self-stigma scale, SSS)和贝克自杀意念量表中文版(Beck scale for suicide ideation-Chinese version, BSI-CV)对某省会城市1 276名AIDS患者进行匿名调查。结果  54.2%(692/1 276)的样本报告自己在过去1周或抑郁最严重时有过自杀意念。多因素分析显示，控制其他因素，歧视知觉(OR=0.57, 95% CI: 0.45~0.72, P < 0.001)与社会支持呈负相关，感染结果告知(OR=1.47, 95% CI: 1.12~1.92, P=0.005)与社会支持呈正相关。歧视知觉(OR=5.53, 95% CI: 4.21~7.27, P < 0.001)与自杀意念呈正相关，社会支持(OR=0.58, 95% CI: 0.45~0.76, P < 0.001)与自杀意念呈负相关。感染结果告知在患者的歧视知觉与社会支持间起部分中介作用(中介效应占总效应比例为29.0%)；社会支持在患者的歧视知觉与自杀意念间起部分中介作用(中介效应占总效应比例为17.5%)。结论  AIDS患者当中有自杀意念的比例较高。低歧视知觉、将感染结果告知家人、朋友及固定伴侣的患者领悟到的社会支持更高。高歧视知觉、低社会支持的患者自杀意念较强。感染结果告知在患者的歧视知觉与社会支持间起部分中介作用，而社会支持则在患者的歧视知觉与自杀意念间起部分中介作用。

The relationship between HIV serostatus disclosure,self-stigma,social support and suicidal ideation in AIDS patients

  Objective  To investigate self-stigma and suicidal ideation in acquired immunodeficiency syndrome (AIDS) patients, and to explore the relationship between self-stigma, suicidal ideation, human immunodeficiency virus (HIV) serostatus disclosure and social support in AIDS patients.  Methods  A total of 1 276 AIDS patients in a provincial capital city were investigated anonymously using the general situation questionnaire, perceived social support scale (PSSS), self-stigma scale (SSS), and Beck scale for suicide ideation-Chinese version (BSI-CV).  Results  54.2% (692/1 276) of the sample reported that they have suicidal ideation in the past week or the most severe depression. Multivariate analysis showed that after controlling for other factors, self-stigma was negatively correlated with social support (OR=0.57, 95% CI: 0.45-0.72, P < 0.001), and HIV serostatus disclosure was positively correlated with social support (OR=1.47, 95% CI: 1.12-1.92, P=0.005); self-stigma was positively correlated with suicidal ideation (OR=5.53, 95% CI: 4.21-7.27, P < 0.001), and social support was negatively correlated with suicidal ideation (OR=0.58, 95% CI: 0.45-0.76, P < 0.001). HIV serostatus disclosure played a partial mediating effect between self-stigma and social support (the mediating effect accounted for 29.0% of the total effect); social support played a partial mediating effect between self-stigma and suicidal ideation (the mediating effect accounted for 17.5% of the total effect).  Conclusions  The proportion of suicidal ideation is higher among AIDS patients. Patients with low self-stigma and who inform family, friends, and regular partners of the infection results perceive higher social support. Patients with high self-stigma and low social support have stronger suicidal ideation. The HIV serostatus disclosure plays a partial mediating role between self-stigma and social support in AIDS patients, while social support plays a partial mediating role between self-stigma and suicidal ideation.