A Systematic Review of Risk Factors for Suicide Among Persons Living with HIV (1996–2020)

Smith, Alexandria; Breazeale, Stephen; Goulet, Joseph L.; Vlahov, David; Justice, Amy C.; Womack, Julie A.

doi:10.1007/s10461-022-03591-y

Cited by 7 publications

(5 citation statements)

References 55 publications

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“…3 One possible explanation might be the survivorship bias, which suggested that PWH with clinical AIDS diagnosis might have died before developing suicide ideation/attempt. 38 Probabilities of suicide ideation/attempt in the late cART cohort were observed to be slightly higher than those in the early cART cohort in this study. The increasing trend of suicide ideation/attempt among PWH could be explained by the elevated risk of psychiatric comorbidities.…”

Section: Discussioncontrasting

confidence: 65%

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Suicide Ideation and Attempt Among People With HIV: A Statewide Population-level Cohort Analysis Between 2005 and 2020

Mi,

Zhang,

Yang

et al. 2024

JAIDS Journal of Acquired Immune Deficiency Syndromes

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Background: Risk factors for suicidality among people with HIV (PWH) may evolve over their disease course, particularly as they develop comorbidities such as mental health disorders over time. Setting: This study compared the leading risk factors of suicide ideation/attempt among PWH in South Carolina across different combination antiretroviral therapy (cART) eras. Methods: A statewide cohort of PWH who were diagnosed between 2005 and 2016, with a follow-up record until 2020, was involved in the study. A Cox proportional hazards model was employed to examine the association of suicide ideation/attempt and predictors including demographics, HIV-related characteristics, and mental health conditions. Results: Among 8,567 PWH, the incidence of suicide ideation/attempt increased from 537.7 per 100,000 person-years (95% Confidence Interval [CI] 460.2-615.1) in the early cART cohort (2005-2008) to 782.5 (95% CI 697.6-867.4) in the late cART cohort (2009-2016). Leading risk factors of suicide ideation/attempt changed across cART cohort. In the early cART cohort, PWH with suicide ideation/attempt were more likely to be White and diagnosed with bipolar disorder (Ps<.05). In the late cART cohort, suicide ideation/attempt was positively associated with transmission through injection drug use, anxiety, post-traumatic stress disorder, schizophrenia, and personality disorder (Ps<.05). Conclusions: Mental health conditions have emerged as more prominent risk factors for suicide ideation/attempt in the late cART cohort. Enhanced access to psychiatric care could facilitate the early identification of mental health conditions, enabling timely counseling or psychosocial interventions that may mitigate mental health issues and, consequently, reduce the likelihood of suicide ideation/attempts among PWH.

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Section: Discussioncontrasting

confidence: 65%

“…3 One possible explanation might be the survivorship bias, which suggested that PWH with clinical AIDS diagnosis might have died before developing suicide ideation/attempt. 38…”

Section: Discussionmentioning

confidence: 99%

Suicide Ideation and Attempt Among People With HIV: A Statewide Population-level Cohort Analysis Between 2005 and 2020

Mi,

Zhang,

Yang

et al. 2024

JAIDS Journal of Acquired Immune Deficiency Syndromes

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“…Included risk factors were based on our original model of suicide risk among PWH [18]. We selected our risk factors based on previous evidence of factors associated with suicide risk among PWH.…”

Section: Risk Factorsmentioning

confidence: 99%

“…We selected our risk factors based on previous evidence of factors associated with suicide risk among PWH. Many of the identified risk factors parallel those in the general population, such as a previous suicide attempt [4,18,19], psychiatric illness [19][20][21][22], alcohol use [19], and drug use [4,19,23]. The role of HIV-specific factors like CD4 þ cell count, HIV-1 RNA, antiretroviral therapy (ART), use of efavirenz (EFV) due to its known adverse side effects, and ART adherence has also been explored, but their associations with suicide remain unclear [4,18,19,23,24].…”

Section: Risk Factorsmentioning

confidence: 99%

Self-injurious unnatural death among Veterans with HIV

Smith,

Goulet,

Vlahov

et al. 2024

Aids

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Objective: People living with HIV (PWH) are at increased risk of suicide and death from unintentional causes compared with people living without HIV. Broadening the categorization of death from suicide to self-injurious unnatural death (SIUD) may better identify a more complete set of modifiable risk factors that could be targeted for prevention efforts among PWH. Design: We conducted a nested case-control study using data from the Veterans Aging Cohort Study (VACS), a longitudinal, observational cohort of Veterans from 2006–2015. A total of 5,036 Veterans with HIV, of whom 461 died by SIUD, were included in the sample. Methods: SIUD was defined using the International Classification of Disease 10th revision cause of death codes. Cases (n = 461) included individuals who died by SIUD (intentional, unintentional, and undetermined causes of death). Controls (n = 4,575) were selected using incidence density sampling, matching on date of birth ± one year, race, sex, and HIV status. SIUD and suicide was estimated using conditional logistic regression. Results: A previous suicide attempt, a diagnosis of an affective disorder, recent use of benzodiazepines, psychiatric hospitalization, and living in the western US significantly increased the risk of suicide and SIUD. Risk factors that appear more important for SIUD than for suicide included a drug use disorder, alcohol use disorder, Hepatitis C, VACS Index 2.0, current smoking, and high pain levels (7–10). Conclusion: Limiting studies to known suicides obscures the larger public health burden of excess deaths from self-injurious behavior. Our findings demonstrate the benefit of expanding the focus to SIUD for the identification of modifiable risk factors that could be targeted for treatment.

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“…Depression is one of the strongest risk factors for suicide and suicidal behaviors among persons living with HIV [9]. Several factors have been identified to be associated with suicidal behaviors, including HIV encephalitis, other psychiatric illnesses, substance use, previous attempts, recent HIV infection (past two years), and transmission from none sexual means such as injection drug use [10]. Other factors that may increase the risk of depression and suicidal behaviors among older individuals include: ageism and stigma, loneliness, decreased social support, neurological changes, declining health, fatigue, changes in appearance, financial distress, and loss of peers [11].…”

Section: Introductionmentioning

confidence: 99%

Depression and Suicidal Ideations among Older Persons Living with HIV/AIDS in Mbarara City, Southwest Uganda

Amanyire,

Aheisibwe,

Kaggwa

et al. 2023

OJPsych

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Background: Due to the increase in longevity and use of antiretroviral treatment, Uganda has had a growing population of older persons living with HIV/AIDS. However, there is a paucity of information on the mental health of the elderly living with HIV/AIDS. In this cross-sectional study, we determined the prevalence of, and associated factors for depression and suicidal ideation among older persons living with HIV/AIDS in Mbarara city, southwest Uganda. Methods: Older persons (150 females, 115 males), with mean age = 64.2 (±5.1) years, accessing health services from three purposively selected HIV/AIDS care centers in Mbarara city, southwest Uganda were recruited. Data on depression and suicidal ideation were collected using a Patient Health Questionnaire (PHQ-9) validated in Uganda, and a structured questionnaire was used to collect data on clinical and socio-demographic characteristics. Data were analysed using logistic regression. Results: Approximately 8.3% and 12.1% had depression and suicidal ideation, respectively. The factors associated with lowering the likelihood of depression were: an increase in the number of family members they stayed with and having no having any problems with their ARVs. On the other hand, earning more than 100,000 Uganda shillings was associated with reducing the risk of suicidal ideations among the participants. Conclusion: Approximately 8 to 12 in 100 older persons living with HIV/AIDS in Uganda have experienced depression or suicidal ideation. Family support and financial control were instrumental factors associated with depression and suicidal ideations, respectively. We recommended strengthening family structures and creating more avenues for How to cite this paper: Amanyire, J.M., Aheisibwe, I., Kaggwa, M.M. and Rukundo, G.Z.

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A Systematic Review of Risk Factors for Suicide Among Persons Living with HIV (1996–2020)

Cited by 7 publications

References 55 publications

Suicide Ideation and Attempt Among People With HIV: A Statewide Population-level Cohort Analysis Between 2005 and 2020

Suicide Ideation and Attempt Among People With HIV: A Statewide Population-level Cohort Analysis Between 2005 and 2020

Self-injurious unnatural death among Veterans with HIV

Depression and Suicidal Ideations among Older Persons Living with HIV/AIDS in Mbarara City, Southwest Uganda

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