绵阳市年轻男男性行为者自杀意念及关联因素分析

目的了解年轻男男性行为者(YMSM)自杀意念现状,分析关联因素。方法以四川省绵阳市15～24周岁男男性行为者为对象,用滚雪球抽样法进行招募调查和血清学检测。关联因素单因素分析用χ2检验,多因素分析用非条件logistic回归。结果共合格调查350人,20. 0%产生过自杀意念,主要为情感因素占45. 7%; 6. 6%实施过自杀。是否有过自杀意念艾滋病病毒(HIV)感染率分别为14. 3%、7. 9%(χ~2=2. 753,P=0. 097)。多因素分析结果:经历性虐待(OR=8. 748)、因性取向受过伤害(OR=2. 529)、性取向自我态度负向(OR=3. 164)、公开性取向受到家人冷落(OR=22. 727)、近6个月商业性行为(OR=4. 630)是YMSM自杀意念的危险因素。结论 YMSM自杀意念发生率高,性虐待及社会、家庭和自我歧视影响明显,增大HIV感染潜在风险。减少歧视性环境和增强未成年人保护,是YMSM自杀危机干预的重要内容。

Suicide ideation and its associated factors among young men who have sex with men in Mianyang City

Objective To investigate the current status of suicide ideation among young men who have sex with men (YMSM), and to analyze the associated factors. Methods MSM aged 15-24 years in Mianyang City, Sichuan Province were recruited by the method of rolling snowball sampling, and then serological examination was performed. Single factors associated with suicide ideation were analyzed by χ² test, while multiple factors by unconditional logistic regression analysis. Results A total of 350 eligible subjects were investigated. 20.0% (70/350) of the subjects had suicide ideation, and 45.7% (32/70) suicide ideation was caused by emotional factors. 6.6% (23/350) committed suicide. The HIV infection rates of subjects with and without suicide ideation were 14.3% and 7.9% (χ²=2.753, P=0.097) respectively. Multivariate analysis showed that having an experience of sexual abuse (OR=8.748), having been hurt due to sexual orientation (OR=2.529), having a negative attitude towards own sexual orientation (OR=3.164), having been snubbed by family members due to sexual orientation (OR=22.727) and having commercial sexual behavior in the last six months (OR=4.630) were the risk factors for suicide ideation in the YMSM. Conclusions The high incidence rate of suicide ideation and the obvious negative impacts of sexual abuse and social-, family- and self-discrimination in YMSM increase the potential risk of HIV infection. Reducing discriminatory environment and enhancing protection of minors are the important contents of suicide crisis intervention in YMSM.