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Zhang H, Li Z, Li P, Fu G, Zhang D, Cheng X, Gao Y, Song W, Zhao H, Han M, Lv F, Wang L. Life expectancy and mental related burden of disease among people living with HIV/AIDS. AIDS Care 2024; 36:15-23. [PMID: 38526977 DOI: 10.1080/09540121.2024.2332444] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2023] [Accepted: 03/14/2024] [Indexed: 03/27/2024]
Abstract
Mental health problems leads to serious disease burden among people living with HIV/AIDS (PLHIV). The study aimed at measuring the mental disorders-caused burden of disease based on PLHIV in mainland China. The data used was from the national HIV/AIDS case reporting system, life expectancy (LE) and LE-eliminated suicide were evaluated by the life-table method. The total YLLs and YLLs caused by suicide in each age group were calculated. The disability weights were estimated by the scale of depression symptoms (CES-D) from the multi-center cross-sectional survey, then calculated the corresponding YLDs as a burden of mental illness among PLHIV. Results showed that the LE had been prolonged by implementing antiviral therapy for PLHIV. The proportion of YLLs caused by suicide was the highest (5·46%) in the 15-24 age group. The YLDs in the 25-34 age group were the highest. The YLLs caused by suicide in males were higher than those in the same age group of females. The YLDs and YLLs were higher in heterosexual-infected PLHIV than in homosexual-infected PLHIV, except for YLLs in the 25-34 age group. In summary, this study first provided localized data on the disease burden caused by mental health problems among PLHIV.
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Affiliation(s)
- Hanxi Zhang
- Beijing Ditan Hospital Capital Medical University, Beijing, People's Republic of China
- National Center for AIDS/STD Control and Prevention, China CDC, Beijing, China
| | - Zheng Li
- National Center for AIDS/STD Control and Prevention, China CDC, Beijing, China
| | - Peilong Li
- National Center for AIDS/STD Control and Prevention, China CDC, Beijing, China
| | - Gengfeng Fu
- Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, People's Republic of China
| | - Dongmin Zhang
- Xuchang Center for Disease Control and Prevention, Xuchang, People's Republic of China
| | - Xiaoli Cheng
- Anhui Provincial Center for Disease Control and Prevention, Hefei, People's Republic of China
| | - Yong Gao
- The first affiliated hospital of USTC, Anhui Provincial Hospital, Hefei, People's Republic of China
| | - Wei Song
- Shenyang Center for Disease Control and Prevention, Shenyang, People's Republic of China
| | - Hongxin Zhao
- Beijing Ditan Hospital Capital Medical University, Beijing, People's Republic of China
| | - Mengjie Han
- Beijing Ditan Hospital Capital Medical University, Beijing, People's Republic of China
| | - Fan Lv
- Beijing Ditan Hospital Capital Medical University, Beijing, People's Republic of China
| | - Lu Wang
- National Center for AIDS/STD Control and Prevention, China CDC, Beijing, China
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Cramer RJ, Robertson RA, Nobles MR, Bowling J, Cacace S, Feinstein BA, Rasmussen S. Entrapment and Defeat Scales: Factor Structure Assessment and Variation by Gender and Sexual Identity among Adults in the United Kingdom. J Pers Assess 2024; 106:254-266. [PMID: 37315196 DOI: 10.1080/00223891.2023.2220400] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2022] [Revised: 05/11/2023] [Accepted: 05/18/2023] [Indexed: 06/16/2023]
Abstract
Entrapment and defeat are empirically-supported suicide risk factors. Their measurement is the subject of some debate, however. Also, limited work exists examining sexual and gender minority (SGM) differences in these suicide risk factors despite overall elevated rates of suicidal thoughts and behaviors (STBs) for SGM persons. The present study examined (1) entrapment and defeat differences by sexual orientation and gender identity, (2) factor structure and criterion validity of the Entrapment Scale (E-Scale) and the Defeat Scale (D-Scale), and (3) measurement invariance by sexual orientation (subsamples were too small for gender identity). A sample of 1,027 adults living in the United Kingdom completed a cross-sectional online questionnaire assessing mental health. Analysis of Variance and Kruskal-Wallis testing revealed: (1) all sexual minority (i.e., gay/lesbian, bisexual, and other SM) persons reported higher internal and external entrapment, defeat, and suicidal ideation compared to their heterosexual counterparts, and; (2) gender minority (i.e., transgender and gender diverse) persons reported higher internal and external entrapment, defeat, and suicidal ideation compared to cisgender persons. Supported by suicide theory, confirmatory factor analysis showed modest support for a two-factor E-Scale (internal and external), and a one-factor D-Scale. All entrapment and defeat scores displayed significant moderate positive correlations with suicidal ideation. E- and D-scale scores displayed high intercorrelation, tempering confidence in conclusions regarding the facture structure findings. Item threshold-level responding varied by sexual orientation for the D-Scale but not the E-Scale. Results are discussed with respect to suicide theory and measurement, public health, and clinical practice.
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Affiliation(s)
- Robert J Cramer
- Department of Public Health Sciences, University of North Carolina at Charlotte
| | - Ryan A Robertson
- Department of Public Health Sciences, University of North Carolina at Charlotte
| | - Matt R Nobles
- Department of Criminal Justice, University of Central Florida
| | - Jessamyn Bowling
- Department of Public Health Sciences, University of North Carolina at Charlotte
| | - Sam Cacace
- Department of Public Health Sciences, University of North Carolina at Charlotte
| | - Brian A Feinstein
- Department of Psychology, Rosalind Franklin University of Medicine and Science
| | - Susan Rasmussen
- School of Psychological Sciences and Health, University of Strathclyde
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Xu C, Wang Z, Liu S, Chen H, Chen Y, Xia D, Chen Y, Xu H, Hu F, Wang Y, Cai Y, Chen J. A nomogram of suicidal ideation among men who have sex with men in China: Based on the integrated motivational-volitional model of suicidal behavior. Front Public Health 2022; 10:1070334. [PMID: 36620248 PMCID: PMC9815603 DOI: 10.3389/fpubh.2022.1070334] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2022] [Accepted: 11/29/2022] [Indexed: 12/24/2022] Open
Abstract
Introduction Men who have sex with men (MSM) are a high-risk group for suicide, with a much higher prevalence of suicidal ideation (SI) than the general population and male population. The aim of this study was to explore the risk factors influencing the development of SI and to develop and validate a nomogram among MSM. Methods A cross-sectional study was conducted in 915 MSM from Shanghai, Shenyang, Shenzhen and Kunming, China using the snowball sampling method. The integrated motivational-volitional (IMV) model of suicidal behavior was used as a theoretical framework to collect different potential influencing factors of SI including diathesis-environment-life events factors and psychosocial factors. The risk factors of SI were screened by logistic regression analysis, and a nomogram for predicting SI were developed. Model properties including discrimination, calibration and decision curves were evaluated to validate the prediction model. Results 882 MSM were included in the statistical analysis, with a lifetime prevalence of SI of 34.4% (303/882). Logistic regression analysis showed that age group, sexual orientation disclosure, high-risk sexual behavior, entrapment, defeat and interpersonal needs were associated with SI. A nomogram was constructed based on the above six predictors. AUC values of ROC for prediction model were 0.761 (0.641-0.770) and 0.754 (0.565-0.822) in the training set (n = 662) and validation set (n = 220), respectively. And there was no statistical difference of the AUC values between the two sets (P > 0.05). The calibration plots of the prediction model in both sets fit well with the ideal model (P > 0.05). The decision curves demonstrated that the threshold probability of prediction model in training set was 1-85%, whereas in validation set was 1-63%. Conclusions The lifetime prevalence of SI among Chinese MSM is high. The nomogram can serve as a useful tool to predict the development of SI among MSM. Defeat, entrapment and interpersonal needs, as significant predictors of SI, can be measured to identify SI in advance. Early assessment of SI and the enhancement of psychosocial interventions are important to prevent suicide-related behaviors. Future studies could incorporate more variables of interest to refine the prediction model to better guide behavioral and psychological intervention strategies among MSM.
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Affiliation(s)
- Chen Xu
- Clinical Research Unit, Tongji University Affiliated Shanghai Pulmonary Hospital, Shanghai, China
| | - Zuxin Wang
- School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Shangbin Liu
- School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Hui Chen
- School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Yingjie Chen
- School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Danni Xia
- School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Yufei Chen
- School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Huifang Xu
- School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Fan Hu
- School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Ying Wang
- School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai, China,*Correspondence: Ying Wang
| | - Yong Cai
- School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai, China,Yong Cai
| | - Jianyu Chen
- College of Public Health, Shanghai University of Medicine and Health Sciences, Shanghai, China,Hongqiao International Medical Research Institute, Shanghai Jiao Tong University School of Medicine, Shanghai, China,Jianyu Chen
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Parra LA, van Bergen DD, Dumon E, Kretschmer T, La Roi C, Portzky G, Frost DM. Family Belongingness Attenuates Entrapment and Buffers Its Association with Suicidal Ideation in a Sample of Dutch Sexual Minority Emerging Adults. ARCHIVES OF SEXUAL BEHAVIOR 2021; 50:983-1001. [PMID: 33398694 DOI: 10.1007/s10508-020-01838-0] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/02/2019] [Revised: 09/07/2020] [Accepted: 09/09/2020] [Indexed: 05/17/2023]
Abstract
Sexual minority emerging adults are more likely to engage in suicidal ideation than their heterosexual counterparts. Experiences of homophobic violence are associated with suicidal ideation. Yet, the specific mechanisms linking homophobic violence to suicidal ideation remain unclear. Entrapment and social belongingness were tested to determine their relevance for understanding the link between homophobic violence and suicidal ideation. A sample of sexual minority Dutch emerging adults (N = 675; ages 18-29, M = 21.93 years, SD = 3.20) were recruited through online platforms and flyers. Homophobic violence was expected to be positively associated with suicidal ideation and entrapment. The association between homophobic violence and suicidal ideation was expected to be indirectly linked through entrapment. We explored whether various sources of social belongingness moderated the path between entrapment and suicidal ideation and whether those sources of social belongingness moderated the indirect effect of homophobic violence on suicidal ideation through entrapment. Results showed that homophobic violence and entrapment were positively associated with suicidal ideation and that family belongingness was negatively associated with suicidal ideation. Homophobic violence and suicidal ideation were not indirectly linked through entrapment. The interaction effect between entrapment and family belongingness was significant, suggesting that, on average, the effect of entrapment on suicidal ideation decreased when family belongingness was high. These results suggest that family belongingness may reduce the association between entrapment and suicidal ideation while adjusting for homophonic violence. Reducing entrapment and improving family belongingness may be useful targets for programs aimed at preventing suicidal ideation among sexual minority emerging adults.
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Affiliation(s)
- Luis A Parra
- Suzanne Dworak-Peck School of Social Work, University of Southern California, Los Angeles, CA, 90089, USA.
- Department of Human Ecology, University of California, Davis, Davis, CA, USA.
- Center for Mind and Brain, University of California, Davis, Davis, CA, USA.
| | - Diana D van Bergen
- Department of Behavioral and Social Sciences, University of Groningen, Groningen, The Netherlands
| | - Eva Dumon
- Department of Head and Skin, Centre of Expertise in Suicide Prevention, Ghent University, Ghent, Belgium
| | - Tina Kretschmer
- Department of Behavioral and Social Sciences, University of Groningen, Groningen, The Netherlands
| | - Chaïm La Roi
- Institute for Futures Studies, Stockholm, Sweden
- Swedish Institute for Social Research, Stockholm University, Stockholm, Sweden
| | - Gwendolyn Portzky
- Department of Head and Skin, Centre of Expertise in Suicide Prevention, Ghent University, Ghent, Belgium
| | - David M Frost
- Department of Social Science, University College London, London, UK
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Hong HJ, Shin SH. Suicidal Ideation of Men with Alcohol Use Disorder in South Korea: A Structural Equation Modeling Analysis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18073353. [PMID: 33805061 PMCID: PMC8036592 DOI: 10.3390/ijerph18073353] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/16/2021] [Revised: 03/16/2021] [Accepted: 03/22/2021] [Indexed: 11/23/2022]
Abstract
South Korea’s suicide rate has been ranked second among OECD countries, and the rate of suicidal ideation is the highest among men with alcohol use disorder. To test a hypothetical model of men with alcohol use disorder based on O’Connor’s integrated motivational-volitional model, a study was conducted at a psychiatric outpatient clinic, a community addiction management center, and an Alcoholics Anonymous meeting in South Korea, comprising 203 men with alcohol use disorder. Data were collected using the Scale for Suicide Ideation, Barratt Impulsiveness Scale-11, Childhood Trauma Questionnaire-Short Form, Survey of Recent Life Experiences-Short Form, Defeat Scale and Entrapment Scale. The final model was a good fit to the data (χ2/df = 1.51, comparative fit index = 0.97, normed fit index = 0.92, incremental fit index = 0.97, Tucker–Lewis index = 0.96, and root mean square error of approximation = 0.05). The structural model explained 34.0% of the variance in suicidal ideation; and it validated that impulsivity, stress, defeat, and entrapment were the key factors affecting suicidal ideation. To prevent suicide among men with alcohol use disorder, it is necessary to develop a suicide prevention program that includes men’s feelings of defeat and entrapment.
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Affiliation(s)
- Hyon Joo Hong
- National Center for Mental Health, Seoul 04933, Korea;
| | - Sung Hee Shin
- College of Nursing Science, Kyung Hee University, Seoul 02447, Korea
- Correspondence: ; Tel.: +82-2-961-0917; Fax: +82-2-961-9398
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Zhang H, Feng Y, Li Z, Xiu X, Wang L. Spatial analysis and risk factors of suicide among people living with HIV/AIDS who committed suicide. Int J STD AIDS 2021; 32:490-500. [PMID: 33570482 DOI: 10.1177/0956462420977972] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Poor mental health may confer worse health outcomes among people living with HIV/AIDS (PLWH). Suicidal behaviors are symptoms of a depressive episode. The goal was to explore characteristics for spatial distribution and risk factors for suicide among PLWH. This study was conducted in Mainland China with the annual newly reported data of PLWH from 2013 to 2018. We compared the spatial distribution differences between the HIV epidemic and suicide mortality and analyzed the global and local spatial analysis of suicide. Further, we explored the possible risk factors of suicide in PLWH by multivariate regression and a decision tree model. High suicide mortality regions in PLWH in China were inconsistent with that of the high prevalence of PLWH, which showed that there was distribution discordance between the HIV epidemic and suicide mortality. Multivariate regression showed that the possible risk factors of PLWH who committed suicide were younger age, with Han nationality, single, having a higher educational level, and homosexual infection route. The decision tree model showed that age was the primary factor. In conclusion, there was a discordance between HIV prevalence and suicide mortality; lower HIV prevalence regions might have higher mortality due to suicide. Concern is merited amongst PLWH with poor mental health.
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Affiliation(s)
- Hanxi Zhang
- National Center for AIDS/STD Control and Prevention, 12415Chinese Center for Disease Control and Prevention, Beijing, China
| | - Yibing Feng
- Yuetan Community Health Service Center, Fuxing Hospital Affiliated to Capital Medical University, Beijing, China
| | - Zheng Li
- National Center for AIDS/STD Control and Prevention, 12415Chinese Center for Disease Control and Prevention, Beijing, China
| | - Xiangfei Xiu
- National Center for AIDS/STD Control and Prevention, 12415Chinese Center for Disease Control and Prevention, Beijing, China
| | - Lu Wang
- National Center for AIDS/STD Control and Prevention, 12415Chinese Center for Disease Control and Prevention, Beijing, China
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Theoretical models of suicidal behaviour: A systematic review and narrative synthesis. THE EUROPEAN JOURNAL OF PSYCHIATRY 2021. [DOI: 10.1016/j.ejpsy.2021.02.002] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
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Sun S, Pachankis JE, Li X, Operario D. Addressing Minority Stress and Mental Health among Men Who Have Sex with Men (MSM) in China. Curr HIV/AIDS Rep 2020; 17:35-62. [PMID: 31950336 PMCID: PMC7050812 DOI: 10.1007/s11904-019-00479-w] [Citation(s) in RCA: 73] [Impact Index Per Article: 18.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
PURPOSE OF REVIEW Men who have sex with men (MSM) in China experience elevated risks of mental health issues in comparison to the general population in China, which contribute to vulnerability to HIV/STI risks and can comprise the effectiveness of HIV prevention efforts. A conceptual framework for understanding this mental health disparity is minority stress theory, which posits that experiences of external prejudice events (i.e., distal stressors) and internal stress processes such as internalized homophobia and concealment (i.e., proximal stressors) contribute to sexual minorities' elevated risk of psychological distress. To deepen the understanding of mental health among Chinese MSM and explore the potential utility of minority stress theory in this population, this paper synthesizes research evidence regarding prevalent mental health issues as well as how minority stress may be linked to psychological health in Chinese MSM. RECENT FINDINGS Results indicate that Chinese MSM experience a high prevalence of several mental health issues including depression, anxiety, suicidal behaviors, and alcohol dependence. This review further reveals minority stress to be an important determinant of psychological distress among Chinese MSM, though evidence is mixed regarding the relationship between proximal minority stress and psychological health. Nonetheless, there is a lack of mental health services and interventions focusing on MSM in China. Culturally relevant, competent, and LGBT-affirmative mental health interventions are needed for Chinese MSM. To guide future intervention research, we provide considerations for reducing minority stress and promoting psychological health among Chinese MSM.
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Affiliation(s)
- Shufang Sun
- Department of Psychiatry and Human Behavior, Brown University Alpert Medical School, 167 Point St, Providence, RI, 02906, USA.
| | - John E Pachankis
- Department of Social and Behavioral Sciences, Yale School of Public Health, New Haven, Connecticut, USA
| | - Xiaoming Li
- Department of Health Promotion, Education, and Behavior, University of South Carolina Arnold School of Public Health, Columbia, SC, 29208, USA
| | - Don Operario
- Department of Behavioral and Social Sciences, Brown School of Public Health, Providence, RI, USA
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Wang Y, Jia M, Yuan D, Liang A, Zhang Z, Jiang X, Chen Y, Zhu H, Luo M, Wang Z, Cai Y. Assessing consistent condom use among migrant men who have sex with men in Shanghai, China: validation of an information-motivation-behavioural skills model. BMC Infect Dis 2019; 19:462. [PMID: 31122201 PMCID: PMC6533705 DOI: 10.1186/s12879-019-4090-4] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2018] [Accepted: 05/14/2019] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND In China, high prevalence of risky sexual behaviours and inequity in health services lead to situations in which migrant men who have sex with men face higher risk of contracting the human immunodeficiency virus. Consistent condom use is a primary means of preventing HIV infection during anal sex among MSM. This study aimed to apply the information-motivation-behavioural skills model to examine the predictors of consistent condom use among migrant MSM in Shanghai, and tested the associations between model constructs. METHODS A cross-sectional study was conducted among 412 migrant MSM in Shanghai. Data on HIV-related information, motivation, behavioural skills, and behaviours were collected via structured questionnaires. A structural equation model was used to assess the IMB model. RESULTS Of the 412 participants, 4.4% reported HIV-positive status, and prevalence of consistent condom use in the previous 6 months was 44.9%. A restricted IMB model provided an acceptable fit to the data. Behavioural skills were found to directly predict consistent condom use (β = 0.629, P < 0.01). Neither information nor motivation could directly predict consistent condom use (P > 0.05), but motivation predicted it indirectly and was mediated by behavioural skills. CONCLUSION The prevalence of consistent condom use was found to be relatively low among migrant MSM in Shanghai. The restricted IMB model was found to be a good predictor of consistent condom use among them. The results of this study indicate that intervention strategies for safer sexual behaviour should not only include information dissemination, but also emphasize motivation and behavioural skills among this population.
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Affiliation(s)
- Ying Wang
- School of Public Health, affiliated with the School of Medicine, Shanghai Jiao Tong University, No.227, South Chongqing Road, Shanghai, 200025 PR China
| | - Mengmeng Jia
- National Cancer Center/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100021 China
| | - Dong Yuan
- Shanghai Municipal Center for Disease Control and Prevention, Shanghai, 200336 China
| | - Ajuan Liang
- Renji Hospital, affiliated with the School of Medicine Shanghai Jiao Tong University, Shanghai, 200127 China
| | - Zhiruo Zhang
- School of Public Health, affiliated with the School of Medicine, Shanghai Jiao Tong University, No.227, South Chongqing Road, Shanghai, 200025 PR China
| | - Xueqin Jiang
- School of Public Health, affiliated with the School of Medicine, Shanghai Jiao Tong University, No.227, South Chongqing Road, Shanghai, 200025 PR China
| | - Yi Chen
- Shanghai Municipal Center for Disease Control and Prevention, Shanghai, 200336 China
| | - Huiyao Zhu
- Changning District Center for Disease Control and Prevention, Shanghai, 200051 China
| | - Mengyun Luo
- School of Public Health, affiliated with the School of Medicine, Shanghai Jiao Tong University, No.227, South Chongqing Road, Shanghai, 200025 PR China
| | - Zezhou Wang
- School of Public Health, affiliated with the School of Medicine, Shanghai Jiao Tong University, No.227, South Chongqing Road, Shanghai, 200025 PR China
| | - Yong Cai
- School of Public Health, affiliated with the School of Medicine, Shanghai Jiao Tong University, No.227, South Chongqing Road, Shanghai, 200025 PR China
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