A Syndemic of Psychosocial Health Disparities and Associations With Risk for Attempting Suicide Among Young Sexual Minority Men
A Syndemic of Psychosocial Health Disparities and Associations With Risk for Attempting Suicide Among Young Sexual Minority Men
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DOI：
10.2105/ajph.2013.301744
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发表时间：
2014-02-01
影响因子：
12.7
通讯作者：
Schnarrs, Phillip W.
中科院分区：
文献类型：
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作者：
Mustanski, Brian;Andrews, Rebecca;Schnarrs, Phillip W.
目标。我们研究了男男性行为（MSM）、男女性行为（MSMW）和女性性行为（MSW）的年轻男性中普遍存在的社会心理健康问题。我们研究了流行病产生的假设驱动因素以及对自杀企图的影响。方法。我们利用来自 11 个司法管辖区的 2005 年和 2007 年青少年危险行为调查的汇总数据集，使用结构方程模型来模拟抑郁症状、药物滥用、危险性行为和亲密伴侣暴力等潜在的流行病因素。多组模型研究了受害和欺凌经历、流行病健康问题和严重自杀企图之间的关系。结果。我们发现，与 MSW 相比，受害经历会增加所有男性青少年的综合症负担，特别是 MSMW 和 MSM（方差解释分别为 44%、38% 和 10%）。与 MSW (OR = 3.47；95% CI = 2.50，4.83；P < .001）。应制定和测试针对多种心理社会健康结果的干预措施，以更好地满足年轻男男性行为者和男男性行为者的需求。
Objectives. We examined a syndemic of psychosocial health issues among young men who have sex with men (MSM), with men and women (MSMW), and with women (MSW). We examined hypothesized drivers of syndemic production and effects on suicide attempts.Methods. Using a pooled data set of 2005 and 2007 Youth Risk Behavior Surveys from 11 jurisdictions, we used structural equation modeling to model a latent syndemic factor of depression symptoms, substance use, risky sex, and intimate partner violence. Multigroup models examined relations between victimization and bullying experiences, syndemic health issues, and serious suicide attempts.Results. We found experiences of victimization to increase syndemic burden among all male youths, especially MSMW and MSM compared with MSW (variance explained = 44%, 38%, and 10%, respectively). The syndemic factor was shown to increase the odds of reporting a serious suicide attempt, particularly for MSM (odds ratio [OR] = 5.75; 95% confidence interval [CI] = 1.36, 24.39; P < .001) and MSMW (OR = 5.08; 95% CI = 2.14, 12.28; P < .001) compared with MSW (OR = 3.47; 95% CI = 2.50, 4.83; P < .001).Conclusions. Interventions addressing multiple psychosocial health outcomes should be developed and tested to better meet the needs of young MSM and MSMW.