背景:自我伤害和自杀的患病率高于艾滋病毒/艾滋病感染者(PLWHA)的普通人群。然而,现有研究报告的结果在中国差异很大。本系统评价和荟萃分析的目的是综合现有的高质量证据,以探讨中国PLWHA人群中自我伤害和自杀的患病率和影响因素。
方法:我们通过PubMed、Embase,WebofScience,科克伦图书馆,SinoMed,CNKI,万方数据库,和CQVIP从成立到2022年9月1日。采用Sata16.0软件进行分析。
结果:共纳入28项研究,样本量为1,433,971,质量评分令人满意,≥5。中国PLWHA的自杀意念(SI)患病率为30%,5%的自杀未遂(SA),8%为自杀计划(SP),7%为自杀未遂(AS),完成自杀为3‰。高柱头(OR=2.94,95CI:1.90-4.57),抑郁症(或,3.17;95CI,2.20-4.57),焦虑(或,3.06;95CI,2.23-4.20),低自尊(或,3.82、95CI、2.22-6.57),高艾滋病毒相关压力(OR,2.53;95CI,1.36-4.72),和失业(OR,2.50;95CI,1.51-4.15)是SI的危险因素;高社会支持(OR,0.61;95CI,0.44-0.84)和配偶感染艾滋病毒(OR,0.39;95CI,0.21-0.74)是SI的保护因素;抑郁(OR,1.62;95CI,1.24-2.13),高侵略性(或,4.66;95CI,2.59-8.39),和更多的负面生活事件(或,2.51;95CI,1.47-4.29)是AS的危险因素;教育水平高(OR,1.31;95CI,1.21-1.43)是CS的危险因素。
结论:数字表明,大约三分之一的PLWHA有自杀意念,在中国,千分之三的人完成了自杀。阳性事件是PLWHA患者自我伤害和自杀的保护因素,而负面事件是危险因素。这表明应将社会心理支持和风险评估纳入PLWHA的护理中。
BACKGROUND: The prevalence of self-injury and suicide is higher than the general population of people living with HIV/AIDS (PLWHA). However, the results reported in existing studies are highly variable in China. The purpose of this systematic review and meta-analysis was to synthesize the currently available high-quality evidence to explore the prevalence and influence factors of self-injury and suicide among PLWHA in China.
METHODS: We retrieve literature written in Chinese and English through databases such as PubMed, Embase, Web of Science, Cochrane Library, SinoMed, CNKI, WanFang Database, and CQVIP from inception to 1 September 2022. Sata 16.0 software was used for analysis.
RESULTS: A total of 28 studies were included with a sample size of 1,433,971 and had a satisfactory quality score of ≥ 5. The prevalence among PLWHA in China were 30% for suicidal ideation (SI), 5% for suicide attempt (SA), 8% for suicide plan (SP), 7% for attempted suicide (AS), and 3‰ for completed suicide. High stigma (OR = 2.94, 95%CI: 1.90 - 4.57), depression (OR, 3.17; 95%CI, 2.20 - 4.57), anxiety (OR, 3.06; 95%CI, 2.23 - 4.20), low self-esteem (OR, 3.82, 95%CI, 2.22 - 6.57), high HIV related stress (OR, 2.53; 95%CI, 1.36 - 4.72), and unemployment (OR, 2.50; 95%CI, 1.51 - 4.15) are risk factors for SI; high social support (OR, 0.61; 95%CI, 0.44 - 0.84) and spouse infected with HIV (OR, 0.39; 95%CI, 0.21 - 0.74) are protective factors for SI; depression (OR, 1.62; 95%CI, 1.24 - 2.13), high aggression (OR, 4.66; 95%CI, 2.59 - 8.39), and more negative life events (OR, 2.51; 95%CI, 1.47 - 4.29) are risk factors for AS; high level of education (OR, 1.31; 95%CI, 1.21 - 1.43) is risk factor for CS.
CONCLUSIONS: Figures indicate that approximately one-third of PLWHA had suicidal ideation, and three out of 1,000 completed suicide in China. Positive events are protective factors for self-injury and suicide among PLWHA, while negative events are risk factors. This suggests that psychosocial support and risk assessment should be integrated into the care of PLWHA.