基于聚类分析的川南地区HIV/AIDS患者社会心理风险分型及相关因素研究OA
Psychosocial Risk Typing and Associated Factors among HIV/AIDS Patients in the Southern Sichuan Region:a Cluster Analysis-Based Study
目的 聚焦川南地区艾滋病(human immunodeficiency virus,HIV/AIDS)患者,通过聚类分析揭示其社会支持、歧视感知、孤独感的聚类特征,识别关键影响因素,旨在为构建社区精准心理干预模式提供依据.方法 采用横断面调查设计,通过多阶段分层随机抽样在川南地区对HIV/AIDS患者进行问卷调查,研究工具包括一般资料及性行为调查表、孤独量表、简化歧视感知量表、社会支持评定量表.在SPSS 27.0软件中采用K-均值聚类法划分潜在类别,并通过单因素分析及多因素Logistic回归模型探究类别差异及影响因素.结果 396份有效问卷中,患者平均年龄为(59.01±12.96)岁,其中男性有261人(65.9%).聚类分析识别出三个组别分别是低社会支持-低歧视-低孤独型(27.8%)、低社会支持-高歧视-高孤独型(45.0%)和高社会支持-低歧视-低孤独型(27.2%).多因素分析显示,与高社会支持-低歧视-低孤独型相比,独居(OR=5.058,95%CI:1.249～20.483)、无个人收入(OR=7.831,95%CI:1.192～51.446)显著增加低社会支持-低歧视-低孤独型风险;已婚/同居(OR=0.152,95%CI:0.037～0.626)、与子女一起(OR=0.218,95%CI:0.048～0.996)、每周锻炼时间≥3 h(OR=0.467,95%CI:0.265～0.823)可减少低社会支持-高歧视-高孤独型风险;确诊后与商业性伴发生过性行为(OR=13.894,95%CI:1.677～115.113)为低社会支持-高歧视-高孤独型的重要风险因素.结论 基于聚类分析揭示川南地区HIV/AIDS患者心理健康风险的异质性,低社会支持-高歧视-高孤独型人群面临显著心理危机,需优先干预.独居、无收入及不良性行为是影响患者归属于不同心理健康风险组别的关键因素.
Objective Focusing on human immunodeficiency virus(HIV/AIDS)patients in southern Sichuan,this study explores the clustering characteristics of their social support,perceived discrimination,and loneliness through cluster analysis.It also identifies key influencing factors to provide a basis for developing a community-based,precision psychological intervention model.Methods A cross-sectional survey design was adopted.Using multistage stratified random sampling,HIV/AIDS patients in southern Sichuan Province were surveyed with questionnaires.The research instruments included a general information and sexual behavior ques-tionnaire,the UCLA Loneliness Scale,the Brief Perceived Discrimination Scale,and the Social Support Rating Scale.K-means clus-tering method in SPSS 27.0 was used to identify potential categories.Univariate analysis and multivariable logistic regression models were employed to explore category differences and influencing factors.Results Among the 396 valid questionnaires,the average age of patients was(59.01±12.96)years,with 261 being male(65.9%).Cluster analysis identified three subgroups:low social support-low discrimination-low loneliness(27.8%),low social support-high discrimination-high loneliness(45.0%),and high social support-low discrimination-low loneliness(27.2%).Multivariate analysis showed that compared to the high social support-low discrimination-low loneliness group,living alone(OR=5.058,95%CI:1.249～20.483)and having no personal income(OR=7.831,95%CI:1.192～51.446)significantly increased the risk of being in the low social support-low discrimination-low loneliness group.Being married/cohabiting(OR=0.152,95%CI:0.037～0.626),living with children(OR=0.218,95%CI:0.048～0.996),and exercising≥3 hours/week(OR=0.467,95%CI:0.265～0.823)reduced the risk of being in the low social support-high discrimination-high loneli-ness group.Post-diagnosis sexual contact with commercial sex partners(OR=13.894,95%CI:1.677～115.113)was a significant risk factor for this group.Conclusion Cluster analysis reveals the heterogeneity of psychological health risks among HIV/AIDS patients in southern Sichuan.Those with low social support,high discrimination,and high loneliness face significant psychological crises and require priority intervention.Living alone,having no income,and engaging in risky sexual behaviour are key factors influencing patients'classification into different mental health risk groups.
陈金玉;范颂;陈润;陈小雪;李爱玲
西南医科大学 公共卫生学院(泸州 646000)西南医科大学 公共卫生学院(泸州 646000)西南医科大学 公共卫生学院(泸州 646000)西南医科大学 公共卫生学院(泸州 646000)西南医科大学 公共卫生学院(泸州 646000)
医药卫生
艾滋病孤独感歧视感知社会支持聚类分析心理健康
Human immunodeficiency virus(HIV/AIDS)LonelinessPerceived discriminationSocial supportCluster analysisMental health
《西南医科大学学报》 2026 (2)
174-180,7
教育部人文社会科学研究青年基金西部和边疆地区项目(24XJCZH002)
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