Psychosocial Syndemic of Suicidal Ideation: A Cross-sectional Study among Sexually Transmitted Infection Patients in Shanghai, China

Abstract

Background: We sought to verify whether psychosocial health problems among patients with sexually transmitted infections (STIs) were associated with these patients’ suicidal ideation and to examine the syndemic effect of multiple psychosocial problems on suicidal ideation. Methods: This was a cross-sectional study of 519 STI patients at the Shanghai Skin Disease Hospital. Demographic, psychosocial, and suicidal ideation information about the participants was collected by questionnaire. Logistic regressions were performed to detect the association between demographic variables and suicidal ideation, as well as each individual psychosocial variable and suicidal ideation, and to verify the syndemic effect of psychosocial factors. Results: Of the participants, 25.0% (130/519) reported having suicidal ideation. In univariable analysis, low self-esteem, loneliness, depression, entrapment, defeat, and unsatisfied interpersonal needs were associated with suicidal ideation. Multivariable analysis found depression (odds ratio [OR]: 4.1; 95% confidence interval [CI]: 2.3–7.2) and entrapment (OR: 2.1; 95%CI: 1.1–4.1) each had a more significant relation with suicidal ideation than the other psychosocial problems examined. STI patients who experienced two or more psychosocial health problems had approximately fourfold odds of suicide ideation (adjusted OR [AOR]: 4.2; 95%CI: 2.6–6.8) compared with those in the non-syndemic group, especially in the high-level (five or more psychosocial problems) group (AOR: 7.0; 95%CI: 3.9–12.5). Conclusions: The study found the participants had a high rate of suicidal ideation and suffered from severe psychosocial problems. These results show a syndemic effect of psychosocial problems on increasing the odds of suicidal ideation. Our findings suggest an urgent need for efforts to prevent suicidal ideation among STI patients toward improving the social and health conditions of this population.

Digital Health Equity: Addressing Power, Usability, and Trust to Strengthen Health Systems

“…In 2019, a Honduran trans woman seeking asylum, Roxana Hernandez, was left to die in ICE (U.S. Immigration and Customs Enforcement) custody after suffering from AIDS-related illness and being refused treatment [123]. Suicidal ideation and depression have been tied to diagnosis of sexually-transmitted infections (STIs) and stigma following infection [124]. Stigma and misinformation related to STIs runs rampant, and disclosure of health information without consent could lead to criminal prosecution in some cases.…”