Suicidal ideation in seropositive patients seen at a South African HIV voluntary counselling and testing clinic
Suicidal ideation in seropositive patients seen at a South African HIV voluntary counselling and testing clinic
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DOI：
10.4314/ajpsy.v15i2.12
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发表时间：
2012-03-01
影响因子：
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通讯作者：
Schlebusch, L.
中科院分区：
文献类型：
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作者：
Govender, R. D.;Schlebusch, L.
目的：自杀行为和HIV/AIDS是重大的公共卫生问题。这项研究的目的是调查那些被转介到自愿艾滋病毒咨询和检测(VCT)诊所并被发现血清阳性的患者的自杀意念。这是为了改善这类患者的自杀预防和干预策略。方法：研究样本包括在三个月期间转诊到大学附属综合州立医院的HIVVCT诊所的自愿成年患者。患者完成了一份关于社会人口统计数据的问卷。在两个时间点(通知后72小时内和6周随访时)使用Beck无望感量表和Beck抑郁量表(BDI)测量自杀意念。所有患者都接受了广泛的检测前和检测后咨询。结果：在190例患者的原始样本中，189例(99.5%)HIV检测结果可用，其中157例(83.1%)检测阳性。更多的女性检测呈阳性，失业和单身/离婚患者也是如此。HIV阳性患者的平均年龄为33.49岁(SD=9.449)，HIV阴性患者的平均年龄为37.94岁(SD=15.238)。年龄是一个重要因素，因为年龄每增加一年，艾滋病毒阳性检测的风险就会下降4.1%。较低的教育程度和传统信仰也与艾滋病毒检测呈阳性密切相关。在72小时内，17.1%(95%可信区间12.16%~23.45%)有自杀意念，6周后24.1%(95%可信区间17.26%~32.39%)出现自杀意念。两个时间点的BDI平均得分分别为15.20和14.23。结论：在研究的血清阳性队列中，有相当数量的人有自杀念头，并且在六周的时间里，自杀意念在这些患者中有所增加。两个时间点的BDI平均得分都表明有临床抑郁症。研究结果还表明，艾滋病毒阳性检测结果与某些社会人口学变量之间存在关联，这些变量可以作为艾滋病毒感染者自杀意念的指标，尽管这还需要进一步研究。虽然自杀意念和艾滋病毒感染之间的关系很复杂，但在艾滋病毒自愿咨询诊所评估患者自杀易感性以及实施自杀预防和管理策略时，自杀意念是一个重要的考虑因素。
Objective: Suicidal behaviour and HIV/AIDS are significant public health concerns. The aim of this study was to investigate suicidal ideation in patients who were referred to a voluntary HIV counselling and testing (VCT) clinic and who were found to be seropositive. This in order to improve suicide prevention and intervention strategies amongst such patients. Method: The sample studied consisted of volunteer adult patients referred over a three-month period to a HIVVCT clinic based at a university-affiliated general state hospital. Patients completed a questionnaire on sociodemographic data. Suicidal ideation was measured using the Beck Hopelessness Scale and the Beck Depression Inventory (BDI), at two time points (within 72 hours after notification and again at a 6 week follow-up). All patients received extensive pre-and post-test counselling. Results: HIV-test results were available for 189 (99.5%) of the original sample of 190 patients studied, with 157 (83.1%) testing positive. More females tested positive as did unemployed and single/divorced patients. The mean age for HIV-positive patients was 33.49 (SD = 9.449), and for HIV-negative patients it was 37.94 (SD = 15.238). Age was a significant factor in that for each year increase in age, the risk of testing HIV-positive decreased by 4.1%. Lower education and traditional beliefs were also significantly associated with testing HIV-positive. At 72 hours suicidal ideation was present in 17.1% (95% confidence interval 12.16% to 23.45%), and at 6 weeks in 24.1% (95% confidence interval 17.26% to 32.39%) of the seropositive patients. Their average BDI scores were 15.20 and 14.23 respectively at the two time points. Conclusion: Suicidal ideation was present in a significant number of the seropositive cohort studied and increased over a six week period among these patients. The average BDI scores at both time points imply a clinical depression. The findings also suggest an association between positive HIV-test results and certain socio-demographic variables that can act as indicators for suicidal ideation in HIV-infected persons, although this requires further research. Although the relationship between suicidal ideation and HIV-infection is complex, it is an important consideration when assessing patient suicide vulnerability at HIV VCT clinics and when implementing suicide prevention and management strategies.