【作者】 陈韵；

【导师】 杨翌；

【作者基本信息】 广东药学院 ， 流行病与卫生统计学， 2011， 硕士

【摘要】 目的:了解佛山市男男性行为人群自杀未遂的发生情况、流行特征及相关因素。为制定男男性行为者自杀危机干预措施提供科学的理论依据。方法:采用现况调查方法,通过同伴推动抽样法招募调查对象,由经统一培训的调查员对佛山市202例男男性行为者进行面对面询问式的问卷调查,获取其社会人口学资料、性取向和性行为相关情况、人格特征、自杀意念和自杀未遂等信息。对收集的资料进行双录入并整理后,使用RDSAT和SPSS对数据进行描述和分析。利用RDSAT计算权重,并导入SPSS进行多因素非条件Logistic回归模型筛选自杀未遂的相关因素。结果: 202例调查对象的年龄范围为18～49岁,中位数（四分位数间距）为29.6 (P₂₅=24.5,P₂₅=36.2)岁。经RDSAT平衡权重计算得到,50.0%调查者的性取向自认为是双性恋（101/202）、39.6%认为是同性恋（80/202）。20.8%（42/202）认为自己的性的吸引力全部来自于同性,43.6%（88/202）认为性的吸引力大部分来源于同性。只有7.0%（14/202）调查对象因为性取向问题而向心理医生或精神科医生求助。有70.1%调查对象（141/202）没有向“圈外人”公开自己的性取向（“出柜”）。大多数人（84.7%,171）近6个月中有和同性发生过肛交性行为。37.0%调查对象肛交性行为肛交时的角色为插入方（75/171）。调查对象的既往自杀未遂率为9.9%（20/202）,调整后自杀未遂率为8.4%（95%CI: 5.0～12.1）。75.0%（15/20）的人发生1次;25%有过多次自杀未遂,其中3人自杀2次,1人自杀3次,1人自杀5次。20例自杀未遂者首次发生自杀未遂的年龄为18～45岁,中位数（四分位间距）为22.8(P₂₅=24.4,P₂₅=33.8)。首次自杀未遂的原因是恋爱问题,首次自杀未遂前一年经历的负性生活事件是学习、工作问题。非条件Logistic回归分析发现,男男性行为人群中的异性恋者、出柜、肛交中为被插入方、冲动性得分较高、攻击性得分较高是自杀未遂的相关因素。结论佛山市男男性行为者自杀未遂率较高,发生自杀未遂是多种因素共同作用的结果。在为该人群提供自杀风险评估和危机干预时,应注意自杀未遂的相关危险因素,预防或减少MSM的自杀行为。更多还原

【Abstract】 Objective: To explore the prevalence, epidemic characteristics and associated factors of attempted suicide among men who have sex with men in Foshan, Guangdong. In order to provide scientific evidence for suicide crisis intervention among men who have sex with men in HIV voluntary counseling and testing service.Methods: Using respondent driven sampling, 202 men who have sex with men were recruited to complete quesetionnaires by face-to-face interview that obtained information about demographic data, suicide and sexual factors, including the time of onset of attempted suicide, sexual-related factors, personality, suicide ideation, suicide attempts and other information. We used RDSAT and SPSS to describe the data. Weight for dependant variable was calculated by RDSAT and imported into SPSS multivariate non-conditional Logistic regression model for related factors of suicide attempts.Results:Among 202 men who have sex with men (MSM), age ranged from 18 to 49 years, with median (interquartile range) of 29.6(24.5~36.2) years. 50.0% of respondents self-reported bisexual sexual orientation (101/202), 39.6% were homosexuals (80/202). 20.8% (42/202) thought that their sexual attractiveness of all was from the same sex, 43.6% (88/202) that comes from most of same-sex sexual attraction. Only 7.0% (14/202) of respondents asked doctors or psychiatrists for help because of sexual orientation issues. 70.1% of respondents (141/202) failed to " out of the closet " to disclose their sexual orientation ("out of the closet"). 84.7% participants had anal sex in the past 6 months. 37.0% (75/171) had receptive anal sex. Lifetime prevalence of suicide attempts among 202 MSM was 9.9% (20/202), the adjusted prevalence of suicide attempts was 8.4% (95% CI: 5.0～12.1). Of 20 subjects who had attempted suicide, 75% (15/20) had once attempted; 25% had attempted suicide several times, including 3 had 2 attempts, 1 had 3 attempts, 1 had 5 times. The first attempted suicide occured at the age of 18 to 45 years, median (interquartile range) 22.8(24.4~33.8). The main reason of first suicide attempt was relationship problems. The main negative life events one year before the firtst attempted suicide was study and work. Unconditional Logistic regression analysis showed that sexual orientation as heterosexual, out of the closet, the role of anal sex as receptive, higher scores of impulsivity, higher scores of aggression were associated factors of suicide attempts.Conclusion There was a high prevalence of suicide attempts among men who have sex with men in Foshan, Guangdong. Attempted suicide occured when a variety of factors exist. We should pay more attention to the associated factors of suicide attempt in suicide risk evaluation and crisis intervention to prevent suicide among men who have sex with men.更多还原