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

庾泳; 苏莉莉; 孙寅萌; 解静; 张丽; 肖水源

doi:10.16462/j.cnki.zhjbkz.2021.12.011

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

doi: 10.16462/j.cnki.zhjbkz.2021.12.011

庾泳^1, ,,
苏莉莉¹,
孙寅萌¹,
解静¹,
张丽¹,
肖水源²

1.
541006 桂林，广西师范大学政治与公共管理学院公共管理系
2.
410078 长沙，中南大学湘雅公共卫生学院社会医学与卫生事业管理学系

基金项目:

湖南省哲学社会学基金 16YBA326

广西高等学校高水平创新团队及卓越学者计划专项经费资助项目 GuiRenCai[2020]6

详细信息

通讯作者:
庾泳，E-mail：yuyongsheyi@163.com

中图分类号: R181
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- 被引次数: 0
出版历程
- 收稿日期: 2021-03-16
- 修回日期: 2021-05-23
- 网络出版日期: 2021-12-27
- 刊出日期: 2021-12-10

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

1.
Department of Public Administration, School of Politics and Public Administration, Guangxi Normal University, Guilin 541006, China
2.
Department of Social Medicine and Health Management, Xiangya School of Public Health, Central South University, Changsha 410078, China

Funds:

Hunan Provincial Philosophy and Sociology Fund Project 16YBA326

Special Funding Project for High-level Innovation Teams and Outstanding Scholars Plan for Guangxi Colleges and University: Research on Emergencies in Guangxi GuiRenCai[2020]6

More Information

Corresponding author: YU Yong, E-mail: yuyongsheyi@163.com

摘要

摘要: 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。
- AIDS /
- HIV感染结果告知 /
- 歧视知觉 /
- 社会支持 /
- 自杀意念
Abstract: 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.
- Acquired immunodeficiency syndrome /
- HIV serostatus disclosure /
- Self-stigma /
- Social support /
- Suicidal ideation

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图 1 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

Figure 1. The relationship between HIV serostatus disclosure, self-stigma, social support and suicidal ideation in AIDS patients

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表 1 过去1周或抑郁最严重时自杀意念单因素分析[n(%)]

Table 1. Univariate analysis of suicidal ideation in the past 1 week or at the the most serve depression [n(%)]

变量	调查对象(n=1 276)	无自杀意念组(n=584)	有自杀意念组(n=692)	χ²值	P值
HIV感染途径				143.62	< 0.001
男男同性行为感染	792(62.1)	259(44.3)	533(77.0)
其他途径感染	484(37.9)	325(55.7)	159(23.0)
性别				0.05	0.820
男	1 224(95.9)	561(96.1)	663(95.8)
女	52(4.1)	23(3.9)	29(4.2)
年龄(岁)				8.11	0.004
≤33	704(55.2)	297(50.9)	407(58.8)
>33	572(44.8)	287(49.1)	285(41.2)
户籍地				10.88	< 0.001
城市	743(58.2)	369(63.2)	374(54.0)
农村	533(41.8)	215(36.8)	318(46.0)
民族				4.58	0.032
汉族	1 192(93.4)	555(95.0)	637(92.1)
少数民族	84(6.6)	29(5.0)	55(7.9)
婚姻状况				0.24	0.623
未婚、离异、丧偶	1 006(71.8)	464(79.5)	542(78.3)
在婚	270(21.2)	120(20.5)	150(21.7)
独生子女				1.38	0.240
是	552(43.3)	263(45.0)	289(41.8)
否	724(56.7)	321(55.0)	403(58.2)
受教育情况				13.35	< 0.001
大学专科、本科在读学生	133(10.4)	41(7.0)	92(13.3)
非在读学生	1 143(89.6)	543(93.0)	600(86.7)
学历				1.07	0.302
本科以下	610(47.8)	270(46.2)	340(49.1)
本科及以上	666(52.2)	314(53.8)	352(50.9)
平均月收入(元)				49.62	< 0.001
≤4 000	535(41.9)	183(31.3)	352(50.9)
>4 000	741(58.1)	401(68.7)	340(49.1)
将感染结果告知家人、朋友、固定伴侣				3.42	0.064
是	970(76.0)	458(78.4)	512(74.0)
否	306(24.0)	126(21.6)	180(26.0)
除AIDS外患有其他慢性病				7.79	0.005
是	418(32.8)	168(28.8)	250(36.1)
否	858(67.2)	416(71.2)	442(63.9)
最近1次体检结果正常				0.58	0.446
是	975(76.4)	452(77.4)	523(75.6)
否	301(23.6)	132(22.6)	169(24.4)
歧视知觉				207.40	< 0.001
低(SSS≤34分)	601(47.1)	403(69.0)	198(28.6)
高(SSS>34分)	675(52.9)	181(31.0)	494(71.4)
社会支持				48.70	< 0.001
低(PSSS≤51分)	636(49.8)	229(39.2)	407(58.8)
高(PSSS>52分)	640(50.2)	355(60.8)	285(41.2)

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表 2 感染结果告知、社会支持中介效应的检验

Table 2. Testing the mediating effect of HIV serostatus disclosure and social support

变量	自变量	因变量	回归方程	β值	s_x	OR(95% CI)值	χ²值	P值
感染结果告知在歧视知觉与社会支持间中介效应的依次检验
第1步	歧视知觉	社会支持	Y=-0.59X	-0.59	0.12	0.50(0.44~0.70)	25.51	< 0.001
第2步	歧视知觉	感染结果告知	M1=-0.45X	-0.45	0.14	0.60(0.49~0.84)	10.48	0.001
第3步	歧视知觉	社会支持	Y=-0.57X	-0.57	0.12	0.57(0.45~0.72)	23.02	< 0.001
	感染结果告知		+0.38M2	0.38	0.14	1.47(1.12~1.92)	7.78	0.005
社会支持在歧视知觉与自杀意念间中介效应的依次检验
第1步	歧视知觉	自杀意念	Y=1.76X	1.76	0.14	5.82(4.44~7.63)	162.58	< 0.001
第2步	歧视知觉	社会支持	M2=-0.57X	-0.57	0.12	0.57(0.45~0.72)	23.02	< 0.001
第3步	歧视知觉	自杀意念	Y=1.71X	1.71	0.14	5.53(4.21~7.27)	150.79	< 0.001
	社会支持		-0.54M2	-0.54	0.14	0.58(0.45~0.76)	15.69	< 0.001

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