Prevalence and correlates of common mental health problems and recent suicidal thoughts and behaviours among female sex workers in Nairobi, Kenya.
Prevalence and correlates of common mental health problems and recent suicidal thoughts and behaviours among female sex workers in Nairobi, Kenya.
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DOI：
10.1186/s12888-021-03515-5
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发表时间：
2021-10-14
期刊：
影响因子：
4.4
通讯作者：
Kimani J
中科院分区：
文献类型：
--
作者：
Beksinska A;Jama Z;Kabuti R;Kungu M;Babu H;Nyariki E;Shah P;Maisha Fiti Study Champions;Nyabuto C;Okumu M;Mahero A;Ngurukiri P;Irungu E;Adhiambo W;Muthoga P;Kaul R;Seeley J;Beattie TS;Weiss HA;Kimani J
不良童年经历（ACE），贫困，暴力和有害的酒精/物质使用与不良的心理健康结果有关，但很少有研究探讨女性性工作者（FSW）的这些风险。我们研究了肯尼亚FSW中常见心理健康问题的患病率和相关性，包括自杀想法和行为。Maisha Fiti是一项纵向研究，研究对象是从内罗毕的性工作者外展方案诊所随机挑选的性工作者。基线行为-生物学调查（n = 1003）数据于2019年6月至12月收集。使用患者健康问卷（PHQ-9）评估抑郁症的心理健康问题，使用广泛性焦虑障碍工具（GAD-7）评估焦虑，使用哈佛创伤问卷（HTQ-17）评估创伤后应激障碍（PTSD），并使用两项工具测量近期自杀想法/行为。其他测量工具包括世卫组织不良童年经历评分、世卫组织暴力侵害妇女问题问卷以及酒精、吸烟和物质参与筛查测试。使用分层建模方法进行描述性统计和多变量logistic回归。在1039名合格的FSW中，1003名FSW参与了研究（应答率：96%），平均年龄为33.7岁。中/重度抑郁的患病率为23.2%，中/重度焦虑的患病率为11.0%，PTSD的患病率为14.0%，近期自杀想法/行为的患病率为10.2%（自杀企图为2.6%，自杀想法为10.0%）。抑郁、焦虑、创伤后应激障碍和最近的自杀想法/行为都与较高的ACE评分、最近的饥饿（上周由于经济困难而错过了一顿饭）、最近的性/身体暴力和有害酒精/物质增加独立相关。PTSD还与衣原体感染率增加和近期自杀想法/行为以及低教育和低社会经济地位相关。心理健康问题在报告社会支助的妇女中不太普遍。心理健康问题的沉重负担表明，需要为FSW量身定制可获得的服务，同时采取结构性干预措施，解决贫困、有害的酒精/药物使用和暴力问题。鉴于ACE的高发病率，应考虑对儿童早期和家庭进行干预，以防止不良的心理健康结果。在线版本包含补充材料，可通过10.1186/s12888-021-03515-5获得。
Adverse childhood experiences (ACEs), poverty, violence and harmful alcohol/substance use are associated with poor mental health outcomes, but few studies have examined these risks among Female Sex Workers (FSWs). We examine the prevalence and correlates of common mental health problems including suicidal thoughts and behaviours among FSWs in Kenya. Maisha Fiti is a longitudinal study among FSWs randomly selected from Sex Worker Outreach Programme (SWOP) clinics across Nairobi. Baseline behavioural-biological survey (n = 1003) data were collected June–December 2019. Mental health problems were assessed using the Patient Health Questionnaire (PHQ-9) for depression, the Generalised Anxiety Disorder tool (GAD-7) for anxiety, the Harvard Trauma Questionnaire (HTQ-17) for Post-Traumatic Stress Disorder (PTSD) and a two-item tool to measure recent suicidal thoughts/behaviours. Other measurement tools included the WHO Adverse Childhood Experiences (ACE) score, WHO Violence Against Women questionnaire, and the Alcohol, Smoking and Substance Involvement Screening Test (ASSIST). Descriptive statistics and multivariable logistic regression were conducted using a hierarchical modelling approach. Of 1039 eligible FSWs, 1003 FSWs participated in the study (response rate: 96%) with mean age 33.7 years. The prevalence of moderate/severe depression was 23.2%, moderate/severe anxiety 11.0%, PTSD 14.0% and recent suicidal thoughts/behaviours 10.2% (2.6% suicide attempt, 10.0% suicidal thoughts). Depression, anxiety, PTSD and recent suicidal thoughts/behaviours were all independently associated with higher ACE scores, recent hunger (missed a meal in last week due to financial difficulties), recent sexual/physical violence and increased harmful alcohol/substance. PTSD was additionally associated with increased chlamydia prevalence and recent suicidal thoughts/behaviours with low education and low socio-economic status. Mental health problems were less prevalent among women reporting social support. The high burden of mental health problems indicates a need for accessible services tailored for FSWs alongside structural interventions addressing poverty, harmful alcohol/substance use and violence. Given the high rates of ACEs, early childhood and family interventions should be considered to prevent poor mental health outcomes. The online version contains supplementary material available at 10.1186/s12888-021-03515-5.
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影响因子：
5
作者：
Dunkle, KL;Jewkes, RK;Harlow, SD
通讯作者：
Harlow, SD
影响因子：
6
作者：
Beattie, Tara S.;Bhattacharjee, Parinita;Heise, Lori
通讯作者：
Heise, Lori
影响因子：
--
作者：
Doyle, K.;Kato-Wallace, J.;Barker, G.
通讯作者：
Barker, G.
DOI：
10.1016/s0140-6736(18)32279-7
发表时间：
2018-11-10
期刊：
Lancet (London, England)
影响因子：
--
作者：
GBD 2017 Disease and Injury Incidence and Prevalence Collaborators
通讯作者：
GBD 2017 Disease and Injury Incidence and Prevalence Collaborators
影响因子：
3.7
作者：
Coetzee J;Buckley J;Otwombe K;Milovanovic M;Gray GE;Jewkes R
通讯作者：
Jewkes R