Exploring effects of multi-level factors on transitions of risk-taking behaviors among middle-to-late adolescents.

Adolescents experiment with risk behaviors, including delinquency, substance use, and sexual activity. Multi-level social factors, such as having high-risk peers, neighborhood risks, and parental monitoring, influence adolescents' behaviors. We modeled transition patterns in Bahamian adolescents' risk behaviors across three high school years and examined the effects of multi-level factors. We collected data from 2,564 Bahamian adolescents in Grade 10 and follow-ups through Grade 12. We used latent transition model to identify adolescents' risk statuses. Further analyses used multinomial logistic regression to explore the effects of multi-level factors on assignment to those latent statuses and transitions. We identified four distinct statuses: "low risk" (47.9% of the sample at baseline), "alcohol use" (36.8%), "alcohol use and sexual activity" (5.5%), and "high risk" (9.8%). Males were more likely to be in higher-risk statuses at baseline and to transition from a lower-risk status in Grade 10 to a higher-risk status in Grade 11. Social risk factors were significantly associated with higher-risk statuses at baseline. Neighborhood risk and peer risk involvement continued to affect transitions from lower to higher risk; parental monitoring did not have a significant effect in later years. Our findings have important implications for developing targeted and developmentally appropriate interventions to prevent and reduce risk behaviors among middle-to-late adolescents.

School connectedness and psychological resilience as mediators in the relationship between childhood abuse and suicidal ideation among Chinese adolescents.

Background: Suicide among adolescents is a huge public health concern around the world. Although childhood abuse has been established as a substantial risk factor for suicide behaviours, potential mediators in this relationship remain unclear.Objective: This study aimed to examine the mediating roles of school connectedness and psychological resilience in the association between childhood abuse and suicidal ideation among Chinese high school students.Methods: The sample involved 1607 adolescents from four high schools in Central China. Structural equation modelling (SEM) was conducted to investigate the mediation effects of school connectedness and psychological resilience on the relationship between childhood abuse and suicidal ideation.Results: The prevalence of suicidal ideation during the past week was 21.9%. Childhood abuse was positively related to the development of suicidal ideation directly and indirectly through school connectedness and psychological resilience. School connectedness and psychological resilience were also partial mediators of all three types of childhood abuse (emotional abuse, physical abuse and sexual abuse) when the types were examined separately.Conclusions: Suicidal ideation was widespread among Chinese high school students. Psychological resilience and school connectedness could attenuate the detrimental impact of childhood abuse on suicidal ideation. Findings underscore the improvement of psychological resilience and the connection to the school would be beneficial to suicide prevention among Chinese adolescents with childhood abuse.

Adolescent suicide is a major public health concern worldwide.Childhood abuse exerts a negative effect on suicide behaviours.School connectedness and psychological resilience mediated the relationship between childhood abuse and suicidal ideation.

Self-perception and COVID-19 vaccination self-efficacy among Chinese adults: A moderated mediation model of mental health and trust.

BACKGROUND: Optimal Corona Virus Disease 2019 (COVID-19) vaccination coverage is necessary to achieve community protection, and self-efficacy independently predict vaccination behavior. The current study examined the effect of self-perception on COVID-19 vaccination self-efficacy as well as potential mechanisms among Chinese adults. METHODS: A cross-sectional survey was conducted from four cities in China (n = 6781). Models 4 and 8 in Hayes' PROCESS macro were used to test models. RESULTS: Self-perception (ß = 0.128, 95 % CI: 0.093, 0.163) and self-perception ∗ mental health (ß = 0.009, 95 % CI: 0.003, 0.014) were positively associated with trust in doctors and vaccine developers, while mental health was negatively related to trust in doctors and vaccine developers (ß = -0.483, 95 % CI: -0.629, -0.337). Self-perception (ß = 0.149, 95 % CI: 0.138, 0.161), trust in doctors and vaccine developers (ß = 0.185, 95 % CI: 0.177, 0.194) and self-perception ∗ mental health (ß = 0.003, 95 % CI: 0.002, 0.005) were positively associated with COVID-19 vaccination self-efficacy. Mental health was negatively related to COVID-19 vaccination self-efficacy (ß = -0.101, 95 % CI: -0.151, -0.051). LIMITATIONS: This cross-sectional study collected data through online questionnaires. CONCLUSIONS: Our results demonstrated that the relationship between self-perception and COVID-19 vaccination self-efficacy was partially mediated by trust in doctors and vaccine developers. Both the correlation between self-perception and COVID-19 vaccination self-efficacy, and the relationship between self-perception and trust in doctors and vaccine developers were moderated by mental health. Findings confirm that increasing COVID-19 vaccination self-efficacy would be facilitated by improvements in self-perception, mental health, and trust in doctors and vaccine developers.

Influence of family structure on adolescent deviant behavior and depression: the mediation roles of parental monitoring and school connectedness.

OBJECTIVES: This study aimed to explore the specific pathway of family structure on adolescent health. STUDY DESIGN: This was a cross-sectional study. METHODS: We examined the influence of family structure on adolescent deviant behavior and depression, as well as the mediation roles of parental monitoring and school connectedness, using the multivariate regression and Karlson-Holm-Breen mediation models. RESULTS: Compared with adolescents in intact families, those in non-intact families showed more deviant behaviors and depression. Parental monitoring and school connectedness appeared to be two important pathways from family structure to deviant behavior and depression. In addition, urban and female adolescents in non-intact families showed more deviant behaviors and depression than their rural and male counterparts, respectively. Furthermore, adolescents in reconstituted families showed more deviant behaviors than those in single-parent families. CONCLUSIONS: The behavioral and mental health of adolescents in single-parent or reconstituted families deserves more attention, and interventions should be actively conducted at both family and school level to improve adolescent health.

The relationship between childhood abuse and depression among adolescents: The mediating role of school connectedness and psychological resilience.

BACKGROUND: Adolescent depression is a major public health concern worldwide, and depressive symptoms among adolescents in Chinese secondary school increase with grade. Although numerous studies noted that childhood abuse was associated with the development of depression in adolescents, the underlying mediators involved in this pathway remain unclear. Therefore, our study aims to explore whether psychological resilience and school connectedness mediate the association between childhood abuse and depression among Chinese adolescents. METHODS: A cross-sectional survey was carried out among 1607 adolescents at four high schools located in Henan Province, Central China. Structural equation modeling was performed to determine whether psychological resilience and school connectedness mediate the influence of childhood abuse on depression. RESULTS: Findings revealed that childhood abuse was directly (ß = 0.410, p < 0.001) and indirectly (ß = 0.141, p < 0.001) related to depression. Specifically, psychological resilience (ß = 0.018, p = 0.009), school connectedness (ß = 0.087, p < 0.001), and school connectedness together with psychological resilience (ß = 0.036, p < 0.001) partially mediated the relationship between childhood abuse and depression. CONCLUSIONS: The detrimental impact of childhood abuse on adolescents' depression may be reduced by fostering psychological resilience and school connectedness.

How workplace violence correlates turnover intention among Chinese health care workers in COVID-19 context: The mediating role of perceived social support and mental health.

AIM: To elucidate the effects of workplace violence on turnover intention among Chinese health care workers, and to identify the potential mediators in this relationship. BACKGROUND: Workplace violence has emerged as a crucial determinant of turnover intention for health care workers. METHODS: A cross-sectional survey was conducted among Chinese health care workers (N = 1,063) between 13 and 20 February 2020. Mediation effects were tested using structural equation modelling with weighted least squares mean and variance adjusted (WLSMV) estimator. RESULTS: Workplace violence had both direct and indirect effects on turnover intention among Chinese health care workers. Specifically, perceived social support, mental health and perceived social support together with mental health partially mediated the relationship between workplace violence and turnover intention. CONCLUSIONS: Chinese health care workers experiencing violence during the COVID-19 outbreak were more likely to report turnover intention. Enhancing social support and reducing mental health problems would be beneficial in decreasing the detrimental effects of workplace violence on turnover intention. IMPLICATIONS FOR NURSING MANAGEMENT: Ensuring health care workers' health and safety is vital in reducing turnover intention, which in turn ascertains continuity of health care delivery. Health care managers should develop targeted interventions to improve social support and prevent post-violence mental health problems.

Factors Associated with Turnover Intention Among Healthcare Workers During the Coronavirus Disease 2019 (COVID-19) Pandemic in China.

PURPOSE: This study assessed the prevalence of turnover intention and explored associated factors on turnover intention among healthcare workers during the COVID-19 pandemic in China. METHODS: An institutional-based cross-sectional study was conducted from July to February 13th to 20th, 2020, in 31 provinces of mainland China. A total of 1403 healthcare workers were recruited. Hierarchical logistic regressions were used to identify potential factors associated with turnover intention among Chinese health care workers. RESULTS: The prevalence of turnover intention among healthcare workers was 10.1% during the COVID-19 pandemic in China. Results of hierarchical regression revealed that working in Grade II hospital (OR = 1.78), technician (OR = 0.30), daily working hours over 12 h (OR = 2.92), frequency of mask replacement between 4 and 8 h (OR = 3.51), refuse volunteer to frontline (OR = 1.68), patient-physician relation unchanged (OR = 1.73), depression (OR = 2.21) and lower social support (OR = 1.75) were significantly associated with the risk of turnover intention. Additionally, healthcare worker's psychosocial syndemic (OR = 6.13) was positively associated with turnover intention. CONCLUSION: Turnover intention is relatively prevalent among healthcare workers during the COVID-19 pandemic in China, and the factors contributing to turnover intention were complex and varied. Early screening of high-risk groups for turnover intention among healthcare workers and more psychosocial health care and physical protection are needed during the COVID-19 pandemic in China.

Classes of childhood adversities and their associations to the mental health of college undergraduates: a nationwide cross-sectional study.

BACKGROUND: Childhood adversities pose deleterious consequences on health and well-being, but limited studies explore whether unique patterns of adverse childhood experiences (ACEs) impact the mental health of emerging adults and the mediating role of current stressful events (CSEs). This study examined classes of ACEs and how they relate to CSEs, psychological distress, and subjective well-being among Eritrean College undergraduates. METHODS: Cross-sectional data on ACEs, CSEs, symptoms of psychological distress, and subjective well-being were collected from a national sample of college students (N = 507). We identified ACE patterns using latent class analysis and further examined whether CSEs mediated the effects of ACE classes on psychological distress and subjective well-being. RESULTS: 86.4% of the sample experienced at least one ACE. Collective violence, domestic violence, and physical abuse were the most common ACEs. Three subgroups, low ACEs (66.3%), household violence (19.1%), and multiple ACEs (14.6%) were identified. We found that relative to low ACEs, household violence (ß = 0.142, 95% CI 0.046, 0.248) and multiple ACEs (ß = 0.501, 95% CI 0.357, 0.666) indirectly influenced psychological distress through CSEs, and CSEs mediated the relationships between household violence (ß = -0.096, 95% CI -0.176, -0.033), multiple ACEs (ß = -0.338, 95% CI -0.498, -0.210), and subjective well-being. However, there were nonsignificant relative direct effects of ACE patterns on both psychological distress and subjective well-being. CONCLUSIONS: Experiencing multiple ACEs and household violence in conjunction with CSEs significantly predict psychological distress and subjective well-being. Contextual interventions for the early identification of ACEs and the management of CSEs may play a crucial role in the prevention of mental health problems.

Healthcare Worker's Mental Health and Their Associated Predictors During the Epidemic Peak of COVID-19.

INTRODUCTION: The outbreak of the coronavirus disease 2019 (COVID-19) poses an unprecedented challenge to healthcare workers (HCWs) globally. This study investigated potential factors related to depression, anxiety, and stress in a sample of Chinese HCWs during the peak of the COVID-19 epidemic. METHODS: An online survey was distributed to Chinese HCWs using respondent-driven sampling. Data were collected between February 13th and February 20th, 2020, immediately following the COVID-19 contagion peak in Hubei. A total of 1208 respondents were eligible for analysis. Mental health problems and social support were measured by the Depression Anxiety Stress Scales-21 (DASS-21) and the Perceived Social Support Scale (PSS). RESULTS: The prevalence rates of depression, (DASS-depression > 9) anxiety (DASS-anxiety > 7) and stress (DASS-stress > 14) were 37.8%, 43.0% and 38.5%, respectively. Multivariate logistic regressions revealed that stress, anxiety, and depression were positively related to lower levels of social support, longer working hours, discrimination experience and workplace violence. The scarcity of medical equipment was correlated with increased stress and depression. Chinese HCWs working at COVID 19 designated hospitals were more likely to report anxiety. Additionally, volunteering to work in the frontline health facilities was inversely associated with depression. CONCLUSION: Mental health problems among Chinese HCWs were alarming during the peak of the COVID-19 epidemic. Health facilities require appropriate and standing services that address the mental health of healthcare workers, particularly during epidemic outbreaks.

Misidentification of Burkholderia pseudomallei, China.

We report a case of melioidosis in China and offer a comparison of 5 commercial detection systems for Burkholderia pseudomallei. The organism was misidentified by the VITEK 2 Compact, Phoenix, VITEK mass spectrometry, and API 20NE systems but was eventually identified by the Bruker Biotyper system and 16S rRNA sequencing.

Mental Health Problems in Chinese Healthcare Workers Exposed to Workplace Violence During the COVID-19 Outbreak: A Cross-Sectional Study Using Propensity Score Matching Analysis.

OBJECTIVE: This study aimed at examining the effect of medical workplace violence (MWV) on the mental health of Chinese healthcare workers during the outbreak of coronavirus disease 2019 (COVID-19). METHODS: An anonymous online survey was issued to Chinese healthcare workers (N=1063) from 31 provinces and autonomous regions between February 13th and February 20th. Mental health was measured by the Chinese Depression Anxiety Stress Scales-21 (DASS-21). Medical workplace violence was measured using a single item, whether any type of workplace violence was experienced during the COVID-19 outbreak. Propensity score matching was used to assess the impact of MWV on mental health. RESULTS: Out of 1063, 217 (20.4%) reported experiencing MWV during the COVID-19 outbreak. Before matching, MWV was correlated with elevated mental health problems (b=8.248, p<0.001), after adjusting for other variables. After matching, Chinese healthcare workers who experienced MWV were more likely to suffer from mental health problems than those who did not. CONCLUSION: MWV exerts a detrimental effect on mental health among Chinese healthcare workers during the COVID-19 outbreak. It is necessary to create a more supportive and safer work environment for healthcare workers at this special context of the COVID-19 outbreak.

Gender-specific temporal trends in overweight prevalence among Chinese adults: a hierarchical age-period-cohort analysis from 2008 to 2015.

Background: As a key health risk, the prevalence of overweight has been strikingly increasing worldwide. This study aimed to disentangle the net age, period, and cohort effects on overweight among Chinese adults by gender. Methods: Data came from the Chinese General Social Survey from 2008 to 2015, which was a repeated cross-sectional survey (n = 55,726, aged 18 and older). χ2 or t tests were used to estimate the gender disparities in overweight and socioeconomic status (SES). A series of hierarchical age-period-cohort cross-classified random-effects models were performed using SAS version 9.4 to estimate the overall and gender-specific temporal trends of overweight, as well as the association between SES and overweight. Further, a series of line charts were used to present the age and cohort variations in overweight. Results: After controlling for covariates, significant age and cohort effects were observed among adults in China (b = 0.0205, p < 0.001; b = 0.0122, p < 0.05; respectively). Specifically, inverted U-shaped age effects were identified for both genders, with a high probability of overweight occurring in middle age (b = -0.0012, p < 0.001). Overweight was more prevalent among men than women before 60 years old, and this trend reversed thereafter (b = -0.0253, p < 0.001). Moreover, men born during the war (before 1950) and reform cohorts (after the 1975s) demonstrated a substantial decline in overweight, while men born in 1950-1975 showed an increasing trend in overweight prevalence (b = 0.0378, p < 0.05). However, the cohort effect on women was not statistically significant. Additionally, a higher SES was related to an elevated probability of overweight. Conclusion: Gender-specific age and cohort effects on the prevalence of overweight were observed among Chinese adults. Both China and other developing countries need to pay attention to the coming obesity challenge and related health inequality. Full life-cycle overweight prevention interventions should focus on middle-aged adults, men born in the war and reform eras, and adults with a higher SES.

Efficacy and safety of antibiotic agents in children with COVID-19: a rapid review.

BACKGROUND: The aim of this review was to evaluate the efficacy and safety of antibiotic agents in children with COVID-19, as well as to introduce the present situation of antibiotics use and bacterial coinfections in COVID-19 patients. METHODS: We searched Cochrane library, Medline, Embase, Web of Science, CBM, Wanfang Data and CNKI from their inception to March 31, 2020. In addition, we searched related studies on COVID-19 published before March 31, 2020 through Google Scholar. We evaluated the risk of bias of included studies, and synthesized the results using a qualitative synthesis. RESULTS: Six studies met our inclusion criteria. Five studies on SARS showed an overall risk of death of 7.2% to 20.0%. One study of SARS patients who used macrolides, quinolones or beta lactamases showed that the mean duration of hospital stay was 14.2, 13.8 and 16.2 days, respectively, and their average duration of fever was 14.3, 14.0 and 16.2 days, respectively. One cohort study on MERS indicated that macrolide therapy was not associated with a significant reduction in 90-day mortality (adjusted OR 0.84, 95% CI: 0.47-1.51, P=0.56) and improvement in MERS-CoV RNA clearance (adjusted HR 0.88, 95% CI: 0.47-1.64, P=0.68). According to the findings of 33 studies, the proportion of antibiotics use ranged from 19.4% to 100.0% in children and 13.2% to 100.0% in adults, despite the lack of etiological evidence. The most commonly used antibiotics in adults were quinolones, cephalosporins and macrolides and in children meropenem and linezolid. CONCLUSIONS: The benefits of antibiotic agents for adults with SARS or MERS were questionable in the absence of bacterial coinfections. There is no evidence to support the use of antibiotic agents for children with COVID-19 in the absence of bacterial coinfection.

Clinical characteristics of children with COVID-19: a rapid review and meta-analysis.

BACKGROUND: Most guidelines on COVID-19 published so far include recommendations for patients regardless of age. Clinicians need a more accurate understanding of the clinical characteristics of children with COVID-19. METHODS: We searched studies reporting clinical characteristics in children with COVID-19 published until March 31, 2020. We screened the literature, extracted the data and evaluated the risk of bias and quality of evidence of the included studies. We combined some of the outcomes (symptoms) in a single-arm meta-analysis using a random-effects model. RESULTS: Our search retrieved 49 studies, including 25 case reports, 23 case series and one cohort study, with a total of 1,667 patients. Our meta-analysis showed that most children with COVID-19 have mild symptoms. Eighty-three percent of the children were within family clusters of cases, and 19% had no symptoms. At least 7% with digestive symptoms. The main symptoms of children were fever [48%, 95% confidence interval (CI): 39%, 56%] and cough (39%, 95% CI: 30%, 48%). The lymphocyte count was below normal level in only 15% (95% CI: 8%, 22%) of children which is different from adult patients. 66% (95% CI: 55%, 77%) of children had abnormal findings in CT imaging. CONCLUSIONS: Most children with COVID-19 have only mild symptoms, and many children are asymptomatic. Fever and cough are the most common symptoms in children. Vomiting and diarrhea were not common in children. The lymphocyte count is usually within the normal range in children.

Effectiveness of intravenous immunoglobulin for children with severe COVID-19: a rapid review.

BACKGROUND: Intravenous immunoglobulin (IVIG) is usually used as supportive therapy, but the treatment of COVID-19 by IVIG is controversial. This rapid review aims to explore the clinical effectiveness and safety of IVIG in the treatment of children with severe COVID-19. METHODS: We systematically searched the literature on the use of IVIG in patients with COVID-19, severe acute respiratory syndrome (SARS) or Middle East respiratory syndrome (MERS), including both adults and children. We assessed the risk of bias and quality of evidence and reported the main findings descriptively. RESULTS: A total of 1,519 articles were identified by initial literature search, and finally six studies met our inclusion criteria, included one randomized controlled trial (RCT), four case series and one case report involving 198 patients. One case series showed the survival of COVID-19 patients with acute respiratory distress syndrome (ARDS) was not improved by IVIG. One case report showed high-dose IVIG could improve the outcome of COVID-19 adults. Three observational studies showed inconsistent results of the effect of IVIG on SARS patients. One RCT showed that IVIG did not reduce mortality or the incidence of nosocomial infection in adults with severe SARS. The quality of evidence was between low and very low. CONCLUSIONS: The existing evidence is insufficient to support the efficacy or safety of IVIG in the treatment of COVID-19.

Associations Between Personality Traits and Patterns of HIV Risk Behaviors Among Young Men Who Have Sex with Men in China.

This study aimed to ascertain the patterns of human immunodeficiency virus (HIV) risk behaviors among young men who have sex with men (YMSM) and explore the relationships between personality traits and patterns of HIV risk behaviors. Three hundred and seventy-five YMSM were recruited from March to December 2013, in central China. Latent class analysis (LCA) was utilized to identify underlying subgroups of HIV risk behaviors; multinomial logistic regression was used to examine predictors of HIV risk behaviors patterns. LCA identified four latent classes: low risk (LR), moderate risk (MR), high risk (HR), and drug use (DU). YMSM reporting high levels of sexual sensation seeking (SSS) tended to be classified to the MR class [adjusted odds ratio (aOR) = 2.96, 95% confidence interval (CI) = 1.33-6.57] and HR class (aOR = 13.77, 95% CI = 3.06-61.96) than the LR class. Those with low degrees of self-control were more likely to be in the HR class (aOR = 4.06, 95% CI = 1.11-14.83) and DU class (aOR = 4.64, 95% CI = 1.50-14.32), compared to LR class. These findings highlight the significance of personality traits on predicting HIV risk behaviors. Future HIV interventions should prioritize YMSM with high SSS and low self-control.

Psychological resilience and current stressful events as potential mediators between adverse childhood experiences and depression among college students in Eritrea.

BACKGROUND: Adverse childhood experiences (ACEs) are well recognized remote risks for adulthood depression. However, proximal processes for this relationship is still an ongoing research endeavor, particularly among college students living in resource-limited settings. The mechanism of the impact of ACEs on depression may be attributed to mediators such as psychological resilience and current stressful events (CSEs). METHODS: Data was obtained using a cross-sectional study from a national representative sample of college undergraduates in Eritrea (N = 507). To explain the mediated effect of ACEs on depression, a mediation analysis using structural equation modeling (SEM) was performed. RESULTS: ACEs were found to have both direct (ß = 0.102, p = 0.023) and indirect (ß = 0.216, p < 0.001) effects on depression. The indirect effect was negatively mediated by psychological resilience and positively by CSEs. Respondents with higher levels of psychological resilience reported lower depressive symptoms and lower ACEs scores, while those with higher scores of either CSEs or ACEs reported more depressive symptoms. CONCLUSIONS: The impact of ACEs on depression may be reduced by managing current stressors and building students' psychological resilience.

Evaluation of small dense low-density lipoprotein concentration for predicting the risk of acute coronary syndrome in Chinese population.

BACKGROUND: Acute coronary syndrome (ACS) is the leading cause of death in developing and developed countries, yet assessing the risk of its development remains challenging. Several lines of evidence indicate that small, dense low-density lipoproteins (sd-LDL) are associated with increased cardiovascular disease risk. We aim to evaluate sd-LDL concentration for predicting the risk of ACS in Chinese population. METHODS: Baseline characteristics of 121 patients with ACS and 172 healthy controls were obtained. Plasma sd-LDL-C was measured using homogeneous assay, and the proportion of sd-LDL-C in LDL-C was detected. RESULTS: There was gender and age effect on the sd-LDL-C concentration and sd-LDL-C/LDL-C ratio among healthy subjects. Elevated sd-LDL-C concentrations and sd-LDL-C/LDL-C ratio were observed in ACS patients with unstable angina pectoris (UAP), non-ST-segment elevation myocardial infarction (STEMI), and ST-segment elevation myocardial infarction (NSTEMI) compared with healthy controls (P < .05); however, there were no differences among ACS groups. According to Pearson's correlation coefficient analyses, sd-LDL-C concentration and sd-LDL-C/LDL-C ratio were positively correlated with triglyceride (TG) and LDL-C concentrations (P < .05) and negatively correlated with high-density lipoprotein (HDL) concentration (P < .05). Based on the receiver operating characteristic (ROC) curves, the cutoff values of sd-LDL-C and sd-LDL-C/LDL-C ratio for the prediction of ACS were 1.06 mmol/L and 34.55%, respectively. Multivariate logistic regression analysis demonstrated that the sd-LDL-C/LDL-C ratio, but not sd-LDL-C concentration, was significantly associated with ACS events [OR (95% CI): 1.24, 1.11-1.38, P < .001]. CONCLUSIONS: The sd-LDL-C/LDL-C ratio may be associated with an increased risk of developing ACS in Chinese population.

HIV Disclosure Patterns and Psychosocial Correlates Among People Living with HIV in Nanjing, China: A Latent Class Analysis.

Little is known about the patterns of HIV disclosure and the predictors of such group memberships. Therefore, our study aimed to explore the relationship between HIV disclosure patterns and psychosocial factors. From July to August 2016, totally 466 people living with HIV (PLWH) were recruited from a tertiary hospital. Latent class analysis was performed to ascertain HIV disclosure patterns, and multinomial logistic regression was used to examine predictors of HIV disclosure patterns. Four classes were identified and characterized as the systematic disclosure (11.2%), systematic concealment (39.5%), disclosure to spouse (29.0%), and disclosure to parents (20.4%). Relative to the systematic concealment class, respondents of the systematic disclosure and disclosure to spouse classes were more likely to report a high level of social support (adjusted odds ratio (aOR) = 1.112, 95% CI = 1.039-1.189; aOR = 1.144, 95% CI = 1.084-1.208). PLWH in the disclosure to spouse class tended to have increased perceived stigma (aOR = 1.040, 95% CI = 1.008-1.073). These findings provide practical implications for effective intervention targeting the different subgroups. Urgent attention should be paid to perceived stigma and social support to encourage PLWH to disclose their HIV status.