广州市青年男男性行为者儿童期性虐待经历对抑郁的影响

洪也婷; 黄莹; 林铠浩; 严瑶; 程伟彬; 杨翌; 江洪波

doi:10.16835/j.cnki.1000-9817.2022.05.016

广州市青年男男性行为者儿童期性虐待经历对抑郁的影响

doi: 10.16835/j.cnki.1000-9817.2022.05.016

1.
广东药科大学公共卫生学院, 广州 510310
2.
广东省第二人民医院人工智能医疗应用研究所

基金项目:

广东省哲学社会科学规划2021年度青年项目 GD21YSH08

国家自然科学基金 81703282

详细信息

作者简介:
洪也婷(1999-), 女, 黑龙江省人, 在读硕士, 主要研究方向为传染病流行病学

通讯作者:
江洪波, E-mail: hongbojiang3@163.com

利益冲突声明 所有作者声明无利益冲突。
中图分类号: R512.91 B844.2
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- 被引次数: 0
出版历程
- 收稿日期: 2021-12-05
- 修回日期: 2022-03-20
- 网络出版日期: 2022-05-20
- 刊出日期: 2022-05-25

Impact of childhood sexual abuse on depression among young men who have sex with men in Guangzhou

1.
School of Public Health, Guangdong Pharmaceutical University, Guangzhou (510310), China

摘要

摘要: 目的了解广州市青年男男性行为者(young men who have sex with men，YMSM)儿童期性虐待(childhood sexual abuse，CSA)经历和抑郁症状的情况，探讨儿童期性虐待对抑郁的影响。方法采用方便抽样的方法，在广州市招募在广州居住时间≥3个月，年龄18~24周岁的365名YMSM作为研究对象，通过电子问卷收集调查对象的人口学特征、寻找性伴方式、性取向、CSA经历和抑郁症状等信息。采用χ²检验比较不同特征YMSM的CSA经历和抑郁情况，采用多因素Logistic回归模型分析CSA经历对抑郁的影响。结果 YMSM中CSA经历和抑郁症状报告率分别为31.51%(115/365)和47.95%(175/365)。初中及以下文化程度(75.00%)以及通过线下寻伴方式(62.22%)的YMSM抑郁症状报告率较高(χ²值分别为7.97，4.19，P值均 < 0.05)。调整了民族、户籍所在地、居住时间、学生、文化程度、个人月收入、性取向、寻伴方式等因素后，多因素Logistic回归模型显示有CSA经历(aOR=1.81，95%CI=1.12~2.93)的YMSM有抑郁症状的可能性高于无CSA经历者。结论广州市YMSM有CSA经历和抑郁症状的比例较高，CSA经历是抑郁症状的危险因素。应注重加强对YMSM的心理干预，尤其是有CSA经历的YMSM，从而减少抑郁症状的比例，提高该人群心理健康水平。
- 同性恋 /
- 男性 /
- 性 /
- 虐待 /
- 抑郁 /
- 回归分析
Abstract: Objective To investigate the experience of child sexual abuse (CSA) and depressive symptoms among young men who sex with men (YMSM) in Guangzhou, and then to explore the impact of CSA on depressive symptoms. Methods A convenient sampling method was used to recruit MSM. YMSM who aged 18-24 and have lived in Guangzhou for more than 3 months were included in this study. Data on demographic characteristics, homosexual partners seeking behaviors, sexual orientation, CSA experience and depression were collected through an electronic questionnaire. χ² tests were used to compare the proportion of CSA and depressive symptoms among YMSM with different characteristics. Logistic regressions were preformed to assess the impact of CSA on depression. Results The proportion of CSA experience and depressive symptoms among participants were 31.51% (115/365) and 47.95% (175/365), respectively. Participants with junior high school education or lower and who sought homosexual partners offline reported(75.00%, 62.22%) a higher proportion of depressive symptoms(χ²=7.97, 4.19, P < 0.05). After adjusting for factors e.g. ethnicity, residence, resident duration in Guangzhou, studentship, education, monthly income, sexual orientation and homosexual partners seeking behaviors, the multivariable Logistic regression model showed that YMSM with CSA experience (aOR=1.81, 95%CI=1.12-2.93) were more likely to have depressive symptoms than those without CSA experience. Conclusion The prevalence of CSA experience and depressive symptom is relatively high among YMSM in Guangzhou, and CSA experience is associated with higher risk of depressive symptoms. More attention should be paid to strengthen the psychological intervention for YMSM, especially for those who experienced CSA, so as to reduce the risk of depression and improve mental health among YMSM.
- Homosexuality /
- Male /
- Sex /
- Torture /
- Derpression /
- Regression analysis
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表 1 不同特征调查对象CSA情况检出率比较

Table 1. Comparison of characteristics among participants of experience of CSA

人口学指标	选项	人数	CSA经历	χ²值	P值
民族^a	汉族	340	106(31.18)		0.77^b
	少数民族	14	5(35.71)
户籍所在地	本市	96	39(40.63)	5.02	0.03
	非本市	269	76(28.25)
居住时间/年	≤1	77	23(29.87)	0.12	0.73
	>1	288	92(31.94)
学生	是	151	59(39.07)	6.83	0.01
	否	214	56(26.17)
文化程度	初中及以下	24	6(25.00)	3.38	0.18
	高中/中专	75	30(40.00)
	大专及以上	266	79(29.70)
个人月收入/元	< 3 000	183	74(40.44)	13.56	<0.01
	≥3 000	182	41(22.53)
性取向	同性恋	272	82(30.15)	0.92	0.34
	非同性恋	93	33(35.48)
寻找性伴方式	线下	45	18(40.00)	1.72	0.19
	线上	320	97(30.31)
注：a存在缺失值；b为Fisher确切概率法检验；线下寻找性伴方式包括酒吧/歌舞厅、茶室/会所、浴池、公园/公厕/草地和其他场所，线上寻找性伴方式包括互联网/交友软件；()内数字为检出率/%。

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表 2 不同特征调查对象抑郁症状检出率比较

Table 2. Comparison of characteristics among participants with depression

人口学指标	选项	人数	抑郁症状	χ²值	P值
民族^a	汉族	340	163(47.94)	0.81	0.37
	少数民族	14	5(35.71)
户籍所在地	本市	96	46(47.92)	< 0.01	1.00
	非本市	269	129(47.96)
居住时间/年	≤1	77	36(46.75)	0.06	0.81
	>1	288	139(48.26)
学生	是	151	73(48.34)	0.02	0.90
	否	214	102(47.66)
文化程度	初中及以下	24	18(75.00)	7.97	0.02
	高中/中专	75	32(42.67)
	大专及以上	266	125(46.99)
个人月收入/元	< 3 000	183	95(51.91)	2.32	0.13
	≥3 000	182	80(43.96)
性取向	同性恋	272	127(46.69)	0.67	0.41
	非同性恋	93	48(51.61)
寻找性伴方式	线下	45	28(62.22)	4.19	0.04
	线上	320	147(45.94)
儿童期性虐待	有	115	67(58.26)	7.16	0.01
	无	250	108(43.20)
注：a存在缺失值；线下寻找性伴方式包括酒吧/歌舞厅、茶室/会所、浴池、公园/公厕/草地和其他场所，线上寻找性伴方式包括互联网/交友软件；()内数字为检出率/%。

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参考文献(23)

[1]	CUI Z, HUANG H, ZHANG T, et al. Low awareness of and willingness to use PrEP in the Chinese YMSM: an alert in YMSM HIV prevention[J]. HIV Med, 2021, 22(3): 185-193. doi: 10.1111/hiv.12990
[2]	MAO X, WANG Z, HU Q, et al. HIV incidence is rapidly increasing with age among young men who have sex with men in China: a multicentre cross-sectional survey[J]. HIV Med, 2018, 19(8): 513-522. doi: 10.1111/hiv.12623
[3]	XU W, ZHENG L, SONG J, et al. Relationship between childhood sexual abuse and HIV-related risks among men who have sex with men: findings from mainland China[J]. Arch Sex Behav, 2018, 47(7): 1949-1957. doi: 10.1007/s10508-017-1104-4
[4]	CHANG X, JIANG X, MKANDARWIRE T, et al. Associations between adverse childhood experiences and health outcomes in adults aged 18-59 years[J]. PLoS One, 2019, 14(2): e211850.
[5]	WILLIAMS J K, WILTON L, MAGNUS M, et al. Relation of childhood sexual abuse, intimate partner violence, and depression to risk factors for HIV among black men who have sex with men in 6 US cities[J]. Am J Public Health, 2015, 105(12): 2473-2481. doi: 10.2105/AJPH.2015.302878
[6]	ZUNG W. Self-Rating Depression Scale[J]. Arch Gen Psychiatry, 1965, 12: 63-70. doi: 10.1001/archpsyc.1965.01720310065008
[7]	XU Y, ZHENG Y. Prevalence of childhood sexual abuse among lesbian, gay, and bisexual people: a Meta-analysis[J]. J Child Sex Abuse, 2015, 24(3): 315-331. doi: 10.1080/10538712.2015.1006746
[8]	MA Y. Prevalence of childhood sexual abuse in China: a Meta-analysis[J]. J Child Sex Abuse, 2018, 27(2): 107-121. doi: 10.1080/10538712.2018.1425944
[9]	TOMORI C, MCFALL A M, SRIKRISHNAN A K, et al. The prevalence and impact of childhood sexual abuse on HIV-risk behaviors among men who have sex with men (MSM) in India[J]. BMC Public Health, 2016, 16: 784. doi: 10.1186/s12889-016-3446-6
[10]	赖志胜, 李艳芳, 卢次勇, 等. 广州市男男性行为者抑郁状况及影响因素分析[J]. 预防医学情报杂志, 2019, 35(12): 1354-1358. https://www.cnki.com.cn/Article/CJFDTOTAL-YFYX201912005.htm LAI Z S, LI Y F, LU C Y, et al. Depression status and related influencing factors of men who have sex with men in Guangzhou City[J]. J Prev Med Inf, 2019, 35(12): 1354-1358. https://www.cnki.com.cn/Article/CJFDTOTAL-YFYX201912005.htm
[11]	高晓娟, 章任重, 李佑芳, 等. 昆明市男男性行为者的抑郁状况及影响因素分析[J]. 中国艾滋病性病, 2018, 24(2): 170-173. https://www.cnki.com.cn/Article/CJFDTOTAL-XBYA201802017.htm GAO X J, ZHANG R Z, LI Y F, et al. Depression and related influential factors among men who have sex with men in Kunming[J]. China J AIDS STD, 2018, 24(2): 170-173. https://www.cnki.com.cn/Article/CJFDTOTAL-XBYA201802017.htm
[12]	谢言, 刘瑛, 杨咏梅. 上海市自愿咨询检测门诊男男性行为者的抑郁症状及相关因素[J]. 中华疾病控制杂志, 2018, 22(12): 1248-1251. XIE Y, LIU Y, YANG Y M. Analysis on depressive symptoms and related factors of men who have sex with men attending HIV voluntary coun-seling and testing clinics in Shanghai[J]. Chin J Dis Control Prev, 2018, 22(12): 1248-1251.
[13]	高迪思, 马迎华, 吴静, 等. 某市青年学生男男性行为人群抑郁状况及影响因素[J]. 中国学校卫生, 2020, 41(12): 1786-1790. doi: 10.16835/j.cnki.1000-9817.2020.12.006 GAO D S, MA Y H, WU J, et al. Depressive symptoms and associated factors of men who have sex with men (MSM) among young people/students in a city[J]. Chin J Sch Health, 2020, 41(12): 1786-1790. doi: 10.16835/j.cnki.1000-9817.2020.12.006
[14]	KIPKE M D, KUBICEK K, AKINYEMI I C, et al. The healthy young men's cohort: health, stress, and risk profile of black and latino Young Men Who Have Sex with Men (YMSM)[J]. J Urban Health, 2020, 97(5): 653-667. doi: 10.1007/s11524-019-00398-6
[15]	王毅, 李六林, 周万明, 等. 绵阳市年轻男男性行为者儿童期性虐待经历对个体行为及心理健康的影响[J]. 中国艾滋病性病, 2018, 24(9): 912-915. https://www.cnki.com.cn/Article/CJFDTOTAL-XBYA201809015.htm WANG Y, LIU L L, ZHOU W M, et al. Impact of childhood sexual abuse experience on individual behavioral and mental health by young men who have sex with man[J]. Chin J AIDS STD, 2018, 24(9): 912-915. https://www.cnki.com.cn/Article/CJFDTOTAL-XBYA201809015.htm
[16]	BLANCO L, NYDEGGER L A, CAMARILLO G, et al. Neurological changes in brain structure and functions among individuals with a history of childhood sexual abuse: a review[J]. Neurosci Biobehav Rev, 2015, 57: 63-69. doi: 10.1016/j.neubiorev.2015.07.013
[17]	PUTNAM F W. Ten-year research update review: child sexual abuse[J]. J Am Academy Child Adolesc Psychiatry, 2003, 42(3): 269-278. doi: 10.1097/00004583-200303000-00006
[18]	KIPKE M D, KUBICEK K, WEISS G, et al. The health and health behaviors of young men who have sex with men[J]. J Adolesc Health, 2007, 40(4): 342-350. doi: 10.1016/j.jadohealth.2006.10.019
[19]	EMETU R E. Perceptions of physical sexual health among young men who have sex with men with a previous history of childhood sexual abuse[J]. J Child Sex Abuse, 2018, 27(5): 554-569. doi: 10.1080/10538712.2018.1484832
[20]	LI J, MO P K H, WU A M S, et al. Roles of self-stigma, social support, and positive and negative affects as determinants of depressive symptoms among HIV infected men who have sex with men in China[J]. AIDS Behav, 2017, 21(1): 261-273. doi: 10.1007/s10461-016-1321-1
[21]	SETH R, SRIVASTAVA R N. Child sexual abuse: management and prevention, and protection of children from Sexual Offences (POCSO) Act[J]. Ind Pediatr, 2017, 54(11): 949-953. doi: 10.1007/s13312-017-1189-9
[22]	PENG J, SHAO J, ZHU H, et al. A systems approach to addressing child maltreatment in China[J]. Child Abuse Neglect, 2015, 50: 33-41. doi: 10.1016/j.chiabu.2015.08.008
[23]	SCHAFER K R, GUPTA S, DILLINGHAM R. HIV-infected men who have sex with men and histories of childhood sexual abuse: implications for health and prevention[J]. J Assoc Nurses AIDS Care, 2013, 24(4): 288-298. doi: 10.1016/j.jana.2012.08.008