Factors associated with deaths from suicide in a French nationwide HIV‐infected cohort

Hentzien, Maxime; Cabie, André; Puglièse, Pascal; Billaud, Éric; Poizot‐Martin, Isabelle; Duvivier, Claudine; Valantin, M.A.; Kaladjian, Arthur; Dramé, Moustapha; Bani‐Sadr, Firouzé

doi:10.1111/hiv.12633

Cited by 23 publications

(31 citation statements)

References 33 publications

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“…Male gender, Swiss nationality, a history of injection drug use, sexual contact between men, or of treatment by a psychiatrist and being at a more advanced clinical stage were thus risk factors for suicide among HIV-positive people living in Switzerland, confirming risk factors found in earlier studies from France and Denmark [9,18]. Of note, there was little evidence that the strength of the associations with these risk factors changed over the study period, in contrast to a previous analysis of the SHCS including data up to the year 2008 [10].…”

Section: Risk Factors For Suicide In People Living With Hivsupporting

confidence: 81%

“…A French study reported that risk factors for suicide among persons living with HIV included a history of intravenous drug use (IDU), alcohol abuse and a history of depression or attempted suicide . In the Swiss study , a history of treatment by a psychiatrist was a predictor of suicide both before and after the introduction of cART, while factors such as advanced clinical stage and gender were important only before cART was introduced.…”

Section: Introductionmentioning

confidence: 99%

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Mortality from suicide among people living with HIV and the general Swiss population: 1988‐2017

et al. 2019

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Introduction In many countries, mortality due to suicide is higher among people living with HIV than in the general population. We aimed to analyse trends in suicide mortality before and after the introduction of triple combination antiretroviral therapy (cART), and to identify risk factors associated with death from suicide in Switzerland. Methods We analysed data from the Swiss HIV Cohort Study from the pre‐cART (1988‐1995), earlier cART (1996‐2008) and later cART (2009‐2017) eras. We used multivariable Cox regression to assess risk factors for death due to suicide in the ART era and computed standardized mortality ratios (SMRs) to compare mortality rates due to suicide among persons living with HIV with the general population living in Switzerland, using data from the Swiss National Cohort. Results and Discussion We included 20,136 persons living with HIV, of whom 204 (1.0%) died by suicide. In men, SMRs for suicide declined from 12.9 (95% CI 10.4‐16.0) in the pre‐cART era to 2.4 (95% CI 1.2‐5.1) in the earlier cART and 3.1 (95% CI 2.3‐4.3) in the later cART era. In women, the corresponding ratios declined from 14.2 (95% CI 7.9‐25.7) to 10.2 (3.8‐27.1) and to 3.3 (95% CI 1.5‐7.4). Factors associated with death due to suicide included gender (adjusted hazard ratio 0.58 (95% CI 0.38‐0.87) comparing women with men), nationality (1.95 (95% CI 1.34‐2.83) comparing Swiss with other), Centers for Disease Control and Prevention clinical stage (0.33 (95% CI 0.24‐0.46) comparing stage A with C), transmission group (2.64 (95% CI 1.71‐4.09) for injection drug use and 2.10 (95% CI 1.36‐3.24) for sex between men compared to other), and mental health (2.32 (95% CI 1.71‐3.14) for a history of psychiatric treatment vs. no history). There was no association with age. Conclusions Suicide rates have decreased substantially among people living with HIV in the last three decades but have remained about three times higher than in the general population since the introduction of cART. Continued emphasis on suicide prevention among men and women living with HIV is important.

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Section: Risk Factors For Suicide In People Living With Hivsupporting

confidence: 81%

Section: Introductionmentioning

confidence: 99%

Mortality from suicide among people living with HIV and the general Swiss population: 1988‐2017

et al. 2019

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“…13 Data thus far have shown General Psychiatry that patient suicide rates within the first year of HIV diagnosis exceed that of the general population. [14][15][16] While the factors leading to suicide may mirror those seen in depression, identifying the risks correlated to suicidality in patients with HIV will inform effective preventative measures against suicide. Furthermore, as discussed above, identifying risk factors of suicidal behaviour can improve HIV management in at-risk populations.…”

Section: Introductionmentioning

confidence: 99%

Rates and risk factors for suicidal ideation, suicide attempts and suicide deaths in persons with HIV: a systematic review and meta-analysis

et al. 2021

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BackgroundPeople living with HIV/AIDS (PLWHA) must contend with a significant burden of disease. However, current studies of this demographic have yielded wide variations in the incidence of suicidality (defined as suicidal ideation, suicide attempt and suicide deaths).AimsThis systematic review and meta-analysis aimed to assess the lifetime incidence and prevalence of suicidality in PLWHA.MethodsPublications were identified from PubMed (MEDLINE), SCOPUS, OVID (MEDLINE), Joanna Briggs Institute EBP and Cochrane Library databases (from inception to before 1 February 2020). The search strategy included a combination of Medical Subject Headings associated with suicide and HIV. Researchers independently screened records, extracted outcome measures and assessed study quality. Data were pooled using a random-effects model. Subgroup and meta-regression analyses were conducted to explore the associated risk factors and to identify the sources of heterogeneity. Main outcomes were lifetime incidence of suicide completion and lifetime incidence and prevalence of suicidal ideation and suicide attempt.ResultsA total of 185 199 PLWHA were identified from 40 studies (12 cohorts, 27 cross-sectional and 1 nested case-control). The overall incidence of suicide completion in PLWHA was 10.2/1000 persons (95%CI: 4.5 to 23.1), translating to 100-fold higher suicide deaths than the global general population rate of 0.11/1000 persons. The lifetime prevalence of suicide attempts was 158.3/1000 persons (95%CI: 106.9 to 228.2) and of suicidal ideation was 228.3/1000 persons (95%CI: 150.8 to 330.1). Meta-regression revealed that for every 10-percentage point increase in the proportion of people living with HIV with advanced disease (AIDS), the risk of suicide completion increased by 34 per 1000 persons. The quality of evidence by Grading of Recommendations, Assessment, Development and Evaluations for the suicide deaths was graded as ‘moderate’ quality.ConclusionsThe risk of suicide death is 100-fold higher in people living with HIV than in the general population. Lifetime incidence of suicidal ideation and attempts are substantially high. Suicide risk assessments should be a priority in PLWHA, especially for those with more advanced disease.

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“…5 Data thus far have shown that patient suicide rates within the first year of HIV diagnosis exceed that of the general population. [6][7][8] Furthermore, societal factors such as stigma, discrimination and lack of social support have been implicated. 9 10 Because the risk factors implicated in suicidality in PLWHA are multifactorial, 11 identifying the risks correlated to suicidal behaviour in patients with HIV may inform effective preventative measures against suicide.…”

Section: Open Accessmentioning

confidence: 99%

Rates and risk factors for suicidal ideation, suicide attempts and suicide deaths in persons with HIV: a protocol for a systematic review and meta-analysis

et al. 2021

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IntroductionThe prevalence of HIV/AIDS is high and is associated with psychiatric morbidity and suicide risk. The objective of this study will be to assess the rates of suicidal ideation, suicide attempts and suicide deaths in people living with HIV/AIDS (PLWHA).Methods and analysisWe present a study protocol for a systematic review and meta-analysis of studies reporting the suicidality outcomes (suicidal ideation, suicide attempts and suicide deaths) in PLWHA. PubMed (MEDLINE), Scopus, EMBASE, Cochrane Library, OVID (HEALTH STAR), OVID (MEDLINE), Joanna Briggs Institute EBP Database, Web of Science and PsychINFO databases will be searched from their inception until 1 January 2020. The primary outcome of interest will be the incidence of suicidality in PLWHA. In addition, we will delineate risk factors associated with suicidality in PLWHA. Citations, full-text articles and abstracts will be screened by four reviewers independently. Disagreements will be resolved through discussion. The study methodological quality (or bias) will be appraised using an appropriate tool. Random-effects meta-analysis will be conducted if we find that the studies are very heterogenous. For the suicidality outcome, probability of suicide risk will be reported. Relative risk ratios (with 95% CIs) will be reported for the effects of the risk factors. Potential publication bias will be assessed by conducting Egger’s test and creating funnel plots. We will conduct additional analyses to explore the potential sources of heterogeneity (eg, age, sex and geographical location).Ethics and disseminationNo ethics clearance is required as no primary data will be collected. The results of this systematic review and meta-analysis will be presented at scientific conferences and published in a peer-reviewed journal. The results may inform clinical management of PLWHA and may guide future population-specific interventions.We will search PubMed (MEDLINE), Scopus, EMBASE, Cochrane Library, OVID (HEALTH STAR), OVID (MEDLINE), Joanna Briggs Institute EBP Database, Web of Science and PsychINFO from their inception until 1 January 2020.PROSPERO registration numberCRD42020161501.

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Factors associated with deaths from suicide in a French nationwide HIV‐infected cohort

Abstract: In the cART era, HIV-related factors are not associated with a higher risk of suicide mortality. Suicide prevention measures should target PLHIV with the psychological morbidities observed in our cohort.

Cited by 23 publications

References 33 publications

Mortality from suicide among people living with HIV and the general Swiss population: 1988‐2017

Mortality from suicide among people living with HIV and the general Swiss population: 1988‐2017

Rates and risk factors for suicidal ideation, suicide attempts and suicide deaths in persons with HIV: a systematic review and meta-analysis

Rates and risk factors for suicidal ideation, suicide attempts and suicide deaths in persons with HIV: a protocol for a systematic review and meta-analysis

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