Risks and predictors of current suicidality in HIV-infected heroin users in treatment in Yunnan, China: a controlled study.
Risks and predictors of current suicidality in HIV-infected heroin users in treatment in Yunnan, China: a controlled study.
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DOI：
10.1097/qai.0b013e31827ce513
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发表时间：
2013-03-01
期刊：
影响因子：
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通讯作者：
HNRC China Collaboration Group
中科院分区：
文献类型：
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作者：
Jin H;Atkinson JH;Duarte NA;Yu X;Shi C;Riggs PK;Li J;Gupta S;Wolfson T;Knight AF;Franklin D;Letendre S;Wu Z;Grant I;Heaton RK;HNRC China Collaboration Group
自杀是中国的一个重要的公共卫生问题。在其他地方，注射吸毒和艾滋病毒感染与自杀独立相关，但研究往往忽视了中国的这些高危人群。我们确定了中国人、艾滋病毒感染者 (HIV+) 和未感染者 (HIV-) 接受治疗的海洛因注射吸毒者 (IDU) 和对照样本的自杀念头频率和预测因素。我们假设，与对照组相比，注射吸毒者中自杀念头的发生率明显更高，并且艾滋病毒阳性注射吸毒者中自杀念头的发生率最高。我们评估了过去两周内，海洛因和艾滋病毒流行交叉省份云南省接受美沙酮治疗的 HIV+（N = 204）和 HIV-（N = 202）海洛因吸毒者的自杀念头，以及人口统计匹配、未感染的非吸毒对照者（N = 201）。注射吸毒者的自杀率高于对照组，但 HIV 感染没有叠加效应（HIV+注射吸毒者 43.1%；HIV-注射吸毒者 37.1%；对照组 8.5%）。在艾滋病毒阳性注射吸毒者中，自杀与既往重度抑郁症病史、社会支持感低以及艾滋病毒相关压力经历等综合因素密切相关，但与艾滋病诊断无关。 HIV-注射吸毒者的自杀倾向与既往重度抑郁症或酗酒病史有关。不到 25% 有自杀倾向的注射吸毒者有情绪或酒精使用诊断史。由于无论艾滋病毒感染状况如何，中国注射吸毒者的自杀意念都很常见，而且过去的精神病史并不能完全解释自杀意念，因此可能需要进行更多研究。
Suicide is an important public health problem in China. Elsewhere injection drug use and HIV infection have independently been associated with suicidality, but research has often overlooked these high-risk groups in China. We determined the frequency and predictors of suicidal ideas in Chinese, HIV-infected (HIV+) and uninfected (HIV-) heroin injection drug users in treatment (IDUs) and a control sample. We hypothesized that rates of suicidal ideas would be significantly higher among IDUs compared to controls, and highest among HIV+ IDUs. We assessed suicidal ideas within the past two weeks in HIV+ (N = 204) and HIV- (N = 202) heroin IDUs in methadone treatment in Yunnan, a province at the intersection of the heroin and HIV epidemics, and in demographically matched, uninfected non-drug using controls (N = 201). Rates of suicidality were higher in IDUs than controls but there was no additive effect of HIV infection (HIV+ IDU 43.1%; HIV- IDU 37.1%; controls 8.5%). Among HIV+ IDUs suicidality was associated most strongly with a combination of prior history of major depression, low perceived social support, and experience of HIV-relevant stress, but not with AIDS diagnosis. Among HIV- IDUs suicidality was associated with prior history of major depressive or alcohol use disorder. Less than 25% of IDUs with suicidality had histories of mood or alcohol use diagnoses. Because suicidal ideation is frequent in IDUs in China, regardless of HIV status, and is not fully accounted for by past psychiatric history, additional research may be warranted.