Analysis Of Current Status And Influencing Factors Of Unprotected Intercourse And Suicidal Ideation In STI Patients

Background:Sexually transmitted infections(STI)refers to infections that are mainly transmitted th rough sexual contact.In recent years,the incidence of STI remains high,and it is now a serious social and public health problem in China.Since STI population have the behavioral characteristic of having unprotected intercour se(UI),and higher suicidal ideation(SI)than those of normal population and other chroni c-disease-affected population.Both physiological physical health problems and psychosocial health problems will be dramatically affected the personal health status,as well as bringi ng a series of social chain reactions.From what have been discussed above,we investigated the UI and SI status of STI patients.At the same time,the influencing factors of the two factors were investigated an d analyzed to provide theoretical support and policy basis for later intervention strategies t o improve the physiological physical health and social health of the population.Method:From January 2018 to December 2018,well-trained investigators conducted a cross-se ctional study in Shanghai Skin Disease Hospital.The questionnaire includes demographic i nformation,relevant knowledge and education about HIV prevention,UI,SI and social psy chosocial status of the respondents.Univariate and multivariate Logistic regression were us ed to analyze the influencing factors of UI and SI,and athe structural equation model wa s constructed.Results:Among 910 responders,the average age is at 38.72±13.03 year old.449 responders(49.3%)had experience of UI within 6 months.218 responders(24.0%)have suicidal desi reideation.54.2%responders have two or more psychosocial problems(syndemic effect)am ong the eight psychosocial problems,depression,entrapment,defeat,self-esteem,loneliness,social support,interpersonal needs and sexual impulsivity.Unprotected Intercourse:Demographic information includes gender,age,sexual orientat ion,from which type of hospital department and type of STI can affect UI.Single factor Univariate analysis found that attitude towards condoms(ORu=1.96,95%CI=1.48-2.60),s kill of using condom(ORu=4.11,95%CI=2.96-5.71),subjective standard of using condo m(ORu=1.52,95%CI=1.17-1.98)and self-effectiveness of using condom(ORu=3.08,95%CI=2.27-4.19)have a statistically significant relationship withinfluence on UI.After adjust ing the influence of demographic information,these 4 factors still have statistically signific ant influence on UI.Multivariate Multi-factor analysis found that level of relevant knowled ge and education about HIV prevention(ORm=0.66,95%CI=0.49-0.90),attitude towards condom(ORm=1.41,95%CI=1.03-1.93),skill of using condom(ORm=3.11,95%CI=2.15-4.50)and self-effectiveness of using condom(ORm=1.91,95%CI=1.35-2.71),subjecti ve standard of using condom and self-effectiveness of using condom(AORm=2.00,95%CI=1.40-2.85),willingness of undergoing VCT(AORm=0.68,95%CI=0.50-0.93)have a statistic ally significant relationship withinfluence on UI.Based on the results of univariate and m ultivariate analysis,combined with the IMB model,with level of relevant knowledge and education about HIV prevention and related judgments included in the information dimensi on,attitude towards condom and subjective standard of using condom included in the moti vation dimension,skill of using condom and self-effectiveness of using condom included i n the skill dimension,UI included in the behavioral dimension,information-motivation-beh avior as the core,the main indicators for the UI factors in STI patients are found to be path coefficient,correlation coefficient and factor load.The fit index of the model is as f ollows:c~2/df=2.465,RMSEA=0.040,GFI=0.993,CFI=0.990,indicating that the model fit was good.Suicidal Ideation:Single Univariatefactor analysis revealed that self-esteem(ORu=2.41,95%CI=1.77-3.29),loneliness(ORu=2.68,95%CI=1.95-3.68),depression(ORu=7.53,95%CI=4.96-11.45),entrapment(ORu=6.08,95%CI=4.38-8.48),defeat(ORu=4.10,95%CI=2.95-5.70),i nterpersonal need(ORu=2.00,94%CI=1.44-2.78)and sexual impulsivity(ORu=1.77,95%CI=1.17-2.68)have statistically significant influence on suicidal ideation.After adjusting the in fluence of demographic factor,these 7 factors still have statistically significant influence o n suicidal ideation.Mltivariate Multivariate analysis showed that depression(ORm=4.51,95%CI=2.87-7.09)and entrapment(ORm=3.33,95%CI=2.31-4.78)have statistically significant influ ence on suicidal ideation.After incorporating 7 demographic factors which have statisticall y significant influence on suicidal ideation,self-esteem(AORm=1.55,95%CI=1.07-2.23),depression(AORm=4.00,95%CI=2.52-6.25)and entrapment(AORm=2.92,95%CI=1.99-4.30)are found to have statistically significant influence on suicidal ideation.Taken depre ssion and distress entrapment as the core,the SI influencing factor model of STI patients was obtained(c~2/df=3.741,RMSEA=0.055,GFI=0.982,CFI=0.983).Discussion and Suggestion:Since when STI patientswent to the hospital,they had already suffered from diseases.According to the four-level prevention strategy,there are more extensive patients who ha ve not been treated and those who are infected but do not know their status themselves.We should not only prevent diseases and disabilities in the second and third levels of pre vention,but also pay attention to the screening of the key population in the first level pre vention and the health promotion of the whole population in the primordial prevention,re productive health and mental health education should be done well in the whole populatio n.Only preventive and preventive medicine is fair and equitable medicine,is the sustain able development of medicine.According to the theory of policy transmission,the preventi on and treatment of sexually transmitted diseases and the control of the epidemic situation must be led by the government,with the participation of the whole people,and the cons truction of a healthy social environment.Thus,health providers and medicine authority,bo th have a mission to translate clinical evidence into decisions and policies to prevent disea se.Every resident should take the task of promoting the overall reproductive health and m ental health of themselves as well as all the society as a social responsibility and obligati on.However,at present,there are still many aspects that can be improved in promoting t he reproductive health and mental health of STI patients in the whole medical system and follow-up management system,as well as the whole population,which also opens up ne w ideas for our follow-up research based on specific problems.