Diverse Rates of Depression Among Men Who Have Sex with Men (MSM) Across India: Insights from a Multi-site Mixed Method Study.
Diverse Rates of Depression Among Men Who Have Sex with Men (MSM) Across India: Insights from a Multi-site Mixed Method Study.
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在印度与男性发生性关系（MSM）的男性抑郁率的不同：多站点混合方法研究的见解。
DOI：
10.1007/s10461-015-1201-0
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发表时间：
2016-02
影响因子：
4.4
通讯作者：
Celentano DD
中科院分区：
文献类型：
--
作者：
Tomori C;McFall AM;Srikrishnan AK;Mehta SH;Solomon SS;Anand S;Vasudevan CK;Solomon S;Celentano DD
不良的心理社会健康导致艾滋病毒危险行为和减少治疗和护理的参与度。本研究使用患者健康问卷-9对印度12个城市的11,992名男男性接触者进行了抑郁及其相关性的调查，并对15个地点的363名男男性接触者进行了定性研究分析。抑郁的总患病率为11%，在不同地点和MSM亚组之间有很大差异，抑郁MSM中自杀念头的发生率很高。在多变量分析中，确认为kothi(女性性认同)[调整后的优势比(AOR)=1.91]、向非家庭成员(AOR=1.7)和家庭成员(AOR=2.4)披露自己是MSM、披露HIV状况(AOR=5.6)以及使用药物与患抑郁症的几率显著相关。定性结果强调了披露MSM和艾滋病毒状况的可怕社会后果，特别是向家庭披露，包括自杀。综合预防干预措施应包括针对披露、自杀和药物使用的精神健康服务。
Poor psychosocial health contributes to HIV risk behavior and reduced engagement in treatment and care. This study investigates depression and its correlates among 11,992 MSM recruited via respondent driven sampling in 12 cities across India using the Patient Health Questionnaire-9 and supplemented by analysis of qualitative research from 15 sites with 363 MSM. Overall prevalence of depression was 11 %, with substantial variation across sites and subgroups of MSM, and high prevalence of suicidal thoughts among depressed MSM. In multivariable analyses identification as a kothi (feminine sexual identity) [adjusted odds ratio (aOR) = 1.91], disclosure of being MSM to non-family (aOR = 1.7) and family (aOR = 2.4), disclosure of HIV-status (aOR = 5.6), and substance use were associated with significantly higher odds of depression. Qualitative results emphasized dire social consequences of disclosing MSM- and HIV- status, especially to family, including suicidality. Combination prevention interventions should include mental health services that address disclosure, suicidality, and substance use.