CAJ | 학술논문

目的：了解我国 HIV 阳性男男性行为人群（MSM）的抑郁、焦虑状况，探讨抑郁、焦虑的相关因素。方法：在 MSM 社区 HIV 感染者小组的帮助下，在 HIV 阳性 MSM 中采用“滚雪球”的方法，共招募 HIV 阳性 MSM 600人，采用电子调查问卷进行调查，获有效问卷541份。使用自编 HIV 阳性 MSM人群健康状况调查表调查研究对象的社会人口学特征及健康行为等，流调中心用抑郁量表（CES-D）和焦虑自评量表（SAS）调查抑郁（CES-D 评分≥16分者为有抑郁症状）、焦虑（SAS 评分≥50分者为有焦虑症状）状况。结果：研究对象抑郁、焦虑症状检出率分别为44.7％（242／541）和25.1％（136／541）。多因素非条件 logistic 回归分析表明，抑郁症状的危险因素包括最近1年考虑过自杀（OR ＝3.31，95％CI：1.73～5.34）、未将 HIV 感染状况告知男性固定性伴（OR ＝0.47，95％CI：0.30～0.73）和被歧视经历评分高（OR ＝1.19，95％CI：1.11～1.29）；与月收入≤1500元者相比，月收入为＞5000元者有抑郁症状的可能性降低（OR ＝0.34，95％CI：0.17～0.71）。焦虑症状危险因素包括最近1年考虑过自杀（OR ＝2.43，95％CI：1.40～4.21）、接受抗病毒治疗（OR ＝1.74，95％CI：1.06～2.84）和被歧视经历评分高（OR ＝1.12，95％CI：1.05～1.20）；与月收入≤1500元者相比，月收入为＞5000元者检出焦虑症状的可能性降低（OR ＝0.44，95％CI：0.20～0.94）。结论：本研究提示 HIV 阳性 MSM 人群抑郁或焦虑症状检出率高，需要引起重视；降低社会歧视、促进性伴交流与支持、改善经济状况可能有助于提高 HIV 阳性 MSM 的心理健康水平。
목적：료해아국 HIV 양성남남성행위인군（MSM）적억욱、초필상황，탐토억욱、초필적상관인소。방법：재 MSM 사구 HIV 감염자소조적방조하，재 HIV 양성 MSM 중채용“곤설구”적방법，공초모 HIV 양성 MSM 600인，채용전자조사문권진행조사，획유효문권541빈。사용자편 HIV 양성 MSM인군건강상황조사표조사연구대상적사회인구학특정급건강행위등，류조중심용억욱량표（CES-D）화초필자평량표（SAS）조사억욱（CES-D 평분≥16분자위유억욱증상）、초필（SAS 평분≥50분자위유초필증상）상황。결과：연구대상억욱、초필증상검출솔분별위44.7％（242／541）화25.1％（136／541）。다인소비조건 logistic 회귀분석표명，억욱증상적위험인소포괄최근1년고필과자살（OR ＝3.31，95％CI：1.73～5.34）、미장 HIV 감염상황고지남성고정성반（OR ＝0.47，95％CI：0.30～0.73）화피기시경력평분고（OR ＝1.19，95％CI：1.11～1.29）；여월수입≤1500원자상비，월수입위＞5000원자유억욱증상적가능성강저（OR ＝0.34，95％CI：0.17～0.71）。초필증상위험인소포괄최근1년고필과자살（OR ＝2.43，95％CI：1.40～4.21）、접수항병독치료（OR ＝1.74，95％CI：1.06～2.84）화피기시경력평분고（OR ＝1.12，95％CI：1.05～1.20）；여월수입≤1500원자상비，월수입위＞5000원자검출초필증상적가능성강저（OR ＝0.44，95％CI：0.20～0.94）。결론：본연구제시 HIV 양성 MSM 인군억욱혹초필증상검출솔고，수요인기중시；강저사회기시、촉진성반교류여지지、개선경제상황가능유조우제고 HIV 양성 MSM 적심리건강수평。
Objective:To know about the prevalence rates of depression and anxiety and its related factors a-mong human immunodeficiency virus (HIV)-infected men who have sex with men (MSM)in China.Methods:Under the help of MSM group,totally 600 HIV-infected MSM were recruited by snowballing sample among HIV-positive MSM,and 541 effective electronic questionnaire were received.Participants completed self-made question-naire of HIV-positive MSM healthy condition which included social demographic and health behavior et al.The Center for Epidemiologic Studies Depression Scale(CES-D)and Self-Rating Anxiety Scale (SAS)were used to survey the condition of depression (CES-D score ≥16)and anxiety (SAS score ≥50)respectively.Results:The percentage of having depression and anxiety symptoms was 44.7% (242 /541)and 25.1% (136 /541)respective-ly.Multiple unconditioned logistic regression analysis showed that the risk of having depressive symptoms included considered suicide in the past year (OR =3.31,95%CI:1.73 -5.34),nondisclosure their HIV infection to male primary sexual partners (OR =0.47,95%CI:0.30 -0.73),discrimination experience (OR =1.19,95%CI:1.11 -1.29).Compared with monthly income of 1500 yuan or less,participants who earned >5000 yuan monthly were less likely to have depressive symptoms (OR =0.34,95%CI:0.17 -0.71).Factors associated with anxiety symp-toms included considered suicide in the past year (OR =2.43,95%CI:1.40 -4.21),accepted antiviral therapy (OR=1.74,95%CI:1.06 ~2.84),discrimination experience (OR =1.12,95%CI:1.05 ~1.20).Participants earned >5000 yuan monthly (OR =0.44,95%CI:0.20 ~0.94)could decrease the risk of having anxiety symptom compared with whose monthly income of 1500 yuan or less.Conclusion:The prevalence rate of depression and anxiety symp-tom among HIV-infected MSM is high and need more attention.It may be helpful to call for the strategy of promo-ting mental health on decreasing social discrimination,communicating with sexual partners,and improving their eco-nomic status.