| Objective: The study aimed to evaluate the occurrence and developing trends of anxiety and depression in MSM population and identify the different trajectories of anxiety and depression in MSM,also to explore the influencing factors of demographic characteristics,social psychological characteristics and AIDS related knowledge,attitude and behavior on anxiety and depression trajectories,which could provide theoretical basis and scientific guidance for the subsequent psychological intervention on MSM.Methods: The study was based on the national "12th Five Year Plan" major science and technology projects,MSM meeting the criteria of inclusion and exclusion were selected for the study.From April 2013 to March 2015,MSM recruited from Western China(Chongqing,Sichuan,Guangxi and Xinjiang clinical trials center)by non-probability sampling method were under a PrEP clinical intervention trial.The subjects were followed up with anxiety and depression measurement every 24 weeks,4 times in total,up to 96 weeks.During baseline and follow-up,we collected the basic demographic characteristics,psychosocial characteristics,AIDSrelated knowledge,attitude,behaviour(including HIV counselling history,STD history,frequency of seeking sexual partners through Internet,etc.),sexual behaviour characteristics(including the number of sexual partners,number of sexual acts,number of condom use),medication information,anxiety and depression of MSM by self-administered questionnaire.Groupbased trajectory model was used to identify different developing trends of anxiety and depression in MSM;logistic regression model was used to explore the influencing factors of different trajectories.Results:(1)According to the inclusion and exclusion criteria,433 MSM were included in the analysis.The incidence rate of anxiety was 24.70%-27.92%,and 33.33%-48.22% of depression during the baseline and four follow-ups.(2)The results of trajectory model showed that anxiety and depression levels had heterogeneity in the longitudinal PrEP study.The best group number of anxiety development trajectories was 3,BIC was-5431.61,low,medium and high anxiety groups accounted for 32.9%,54.8% and 12.3% respectively;the best group number of depression development trajectories was 2,BIC was-5421.0,low depression and high depression groups accounted for 71.9% and 28.1% respectively.The AvePP of corresponding groups is both greater than 0.7.At the same time,the results of generalized estimation equation showed that there were statistical differences in different development trajectories groups of anxiety and depression.(3)Multivariate logistic regression analysis showed that in anxiety,MSM who had higher education level(Senior high school / vocational high school / technical secondary school vs.junior high school and below,OR=0.451,95%CI=0.212-0.957,Junior high school,undergraduate or above vs.junior high school and below,OR=0.431,95%CI=0.213-0.870),had higher score of HIV-related knowledge(OR=0.872,95%CI=0.803-0.948),had lower frequency of seeking sexual partners on Internet(sometimes or occasionally vs.often,OR=0.406,95% CI=0.189-0.868),didn’t have a history of STD(OR=0.461,95%CI=0.234-0.912)were less likely to have a high anxiety development trajectory,MSM who felt a great threat of HIV to themselves/family(very large vs.General and below,OR=2.155,95%CI=1.298-3.578)and felt being discriminated against by doctor(OR=2.224,95%CI=1.227-4.031)were more likely to have a high anxiety development trajectory;in depression,MSM who had higher education level(high school / vocational high school / secondary school vs.Junior high school and below,OR=0.401,95% CI=0.167-0.962;junior college,undergraduate and above,OR=0.285,95% CI=0.124-0.653),had higher score of HIV-related knowledge(OR=0.830,95%CI=0.746-0.923),had lower frequency of seeking sexual partners on Internet(sometimes or occasionally vs.regular,OR=0.309,95% CI=0.131-0.732;never vs.regular,OR=0.405,95%CI=0.164-0.999),had lower drinking frequency(at least 3 times / week,OR=0.325,95%CI=0.157-0.672;never vs.At least 3 times / week,OR=0.412,95%CI=0.188-0.899),didn’t have a history of STD(OR=0.447,95% CI=0.202-0.987),didn’t worry of discrimination from others(a little or no vs.quite worried,OR=0.484,95% CI=0.263-0.893)were less likely to have a high depression development trajectory,MSM who felt high HIV infection risk of MSM around(very high vs.general and below,OR=2.324,95% CI=1.159-4.663),felt a great threat of HIV to themselves/family(very large vs.general or below,OR=2.690,95% CI=1.213-5.965;large vs.general or below,OR=3.512,95% CI=1.407-8.769),were bisexual(OR=1.933,95% CI=1.093-3.419)and felt being discriminated against by doctor(OR=2.326,95% CI=1.149-4.707)were more likely to have a high depression development trajectory.Conclusion:(1)The incidence rate of anxiety and depression among MSM in Western China was high,and the development trajectories of MSM had heterogeneous in the longitudinal study,so it is necessary to identify the trajectories and especially focus on the mental health of MSM with high anxiety and depression development trajectories;(2)basic demographic characteristics,psychosocial characteristics,AIDS-related knowledge,attitude and behavior both affected the development trajectories of anxiety and depression.Therefore,on the one hand,we should pay more attention to MSM with low education and bisexuality and a history of STD,and provide effective psychological guidance in time;on the other hand,we should improve the social support of MSM,including the establishment of gay community and the reduction of social discrimination,meanwhile,we ought to carry out corresponding behavior intervention on MSM,popularize AIDS health education and advocate safe sex. |
