The Relationship Between Sexual Behavior Stigma and Depression Among Men Who have Sex with Men and Transgender Women in Kigali, Rwanda: a Cross-sectional Study.
The Relationship Between Sexual Behavior Stigma and Depression Among Men Who have Sex with Men and Transgender Women in Kigali, Rwanda: a Cross-sectional Study.
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卢旺达基加利与男性发生性关系的男性与跨性别女性的性行为污名与抑郁症之间的关系：一项横断面研究。
DOI：
10.1007/s11469-021-00699-5
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发表时间：
2022-12
影响因子：
8
通讯作者：
Baral, Stefan
中科院分区：
文献类型：
--
作者：
Okonkwo, Nneoma;Rwema, Jean Olivier Twahirwa;Lyons, Carrie;Liestman, Benjamin;Nyombayire, Julien;Olawore, Oluwasolape;Nsanzimana, Sabin;Mugwaneza, Placidie;Kagaba, Aflodis;Sullivan, Patrick;Allen, Susan;Karita, Etienne;Baral, Stefan
评估性行为污名作为卢旺达基加利男男性行为者（MSM）和跨性别女性（TGW）抑郁症状的决定因素的作用。在2018年3月至8月期间，采用应答者驱动抽样（RDS）招募了年龄≥18岁的MSM/TGW。使用患者健康问卷（PHQ-9）评估心理健康状况。来自朋友和家人，医护人员和社区成员的性行为耻辱感使用经过验证的工具进行评估。采用多项logistic回归模型分析性行为污名与抑郁症状和抑郁之间的关系。二次分析进一步比较了MSM和TGW之间的抑郁和抑郁症状。在纳入的736名参与者中，14%（106/736）被确定为TGW。抑郁症8.9%（RDS校正，7.6%; 95%CI，4.6-10.6）和轻度/中度抑郁症状26.4%（RDS校正，24.1%; 95%CI，19.4-28.7）在TGW中常见，高于MSM（p < 0.001）。预期（41%），感知（36%）和制定（45%）的耻辱是非常普遍的，也显着较高的TGW（p < 0.001）。在多变量RDS校正分析中，预期（相对风险比（RRR），1.88; 95%CI，1.11-3.19）和感知（RRR，2.06; 95%CI，1.12-3.79）的耻辱与抑郁症状的患病率较高。预期（RRR，4.78; 95%CI，1.74-13.13）和制定（RRR，3.09; 95%CI，1.61-5.93）的耻辱也与抑郁症的患病率较高。在二次分析中，调整污名后，MSM和TGW之间的显着差异消失。这些数据表明，在基加利的男男性行为者/过渡期女青年中，抑郁症状和抑郁负担很高。从概念上讲，污名化是男男性行为者和TGW之间的心理健康压力可能的前因，这表明扩大污名化缓解干预措施的潜在效用，以改善卢旺达性和性别少数群体的生活质量和心理健康结果。
To evaluate the role of sexual behavior stigma as a determinant of depressive symptoms among men who have sex with men (MSM) and transgender women (TGW) in Kigali, Rwanda. MSM/TGW aged ≥18 years were recruited using respondent-driven sampling (RDS) between March–August, 2018. Mental health was assessed using the Patient Health Questionnaire (PHQ-9). Sexual behavior stigma from friends and family, healthcare workers, and community members was assessed using a validated instrument. Multinomial logistic regression models were used to determine the association between sexual behavior stigma and depressive symptoms and depression. Secondary analyses further compared depression and depressive symptoms among MSM and TGW. Among the 736 participants included, 14% (106/736) identified as TGW. Depression 8.9% (RDS-adjusted, 7.6%; 95% CI, 4.6–10.6) and mild/moderate symptoms of depression 26.4% (RDS-adjusted, 24.1%; 95% CI, 19.4–28.7) were common and higher among TGW compared to MSM (p < 0.001). Anticipated (41%), perceived (36%), and enacted (45%) stigmas were highly prevalent, and were also significantly higher among TGW (p < 0.001). In multivariable RDS-adjusted analysis, anticipated (relative risk ratio (RRR), 1.88; 95% CI, 1.11–3.19) and perceived (RRR, 2.06; 95% CI, 1.12–3.79) stigmas were associated with a higher prevalence of depressive symptoms. Anticipated (RRR, 4.78; 95% CI, 1.74–13.13) and enacted (RRR, 3.09; 95% CI, 1.61–5.93) stigmas were also associated with a higher prevalence of depression. In secondary analyses, the significant differences between MSM and TGW were lost after adjusting for stigma. These data demonstrate a high burden of depressive symptoms and depression among MSM/TGW in Kigali. Conceptually, stigma is a likely antecedent of mental health stress among MSM and TGW suggesting the potential utility of scaling up stigma mitigation interventions to improve the quality of life and mental health outcomes among sexual and gender minority communities in Rwanda.
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DOI：
10.1001/jama.2017.3826
发表时间：
2017-04-18
期刊：
JAMA
影响因子：
--
作者：
Friedrich, M J
通讯作者：
Friedrich, M J
影响因子：
1.7
作者：
Ahaneku H;Ross MW;Nyoni JE;Selwyn B;Troisi C;Mbwambo J;Adeboye A;McCurdy S
通讯作者：
McCurdy S
影响因子：
4.4
作者：
Chakrapani, Venkatesan;Willie, Tiara C.;Kershaw, Trace S.
通讯作者：
Kershaw, Trace S.
影响因子：
168.9
作者：
Beyrer, Chris;Baral, Stefan D.;van Griensven, Frits;Goodreau, Steven M.;Chariyalertsak, Suwat;Wirtz, Andrea L.;Brookmeyer, Ron
通讯作者：
Brookmeyer, Ron
影响因子：
3.9
作者：
Herek, Gregory M.;Gillis, J. Roy;Cogan, Jeanine C.
通讯作者：
Cogan, Jeanine C.