Prevalence and Associated Factors of Suicidal Ideation and Attempt among People Living with HIV/AIDS at Zewditu Memorial Hospital, Addis Ababa, Ethiopia: A Cross-Sectional Study

Abstract

Background. Human Immune Deficiency Virus (HIV/AIDS) continues to be an underrecognized risk for suicidal ideation, suicidal attempt, and completion of suicide. Suicidal ideation and attempt in HIV/AIDS is not only a predictor of future attempted suicide and completed suicide. Methods. An institution based cross-sectional study was conducted among HIV-positive patients attending HIV care at Zewditu Memorial Hospital. Systematic random sampling technique was used to recruit 423 participants from April to May 2014. Composite International Diagnostic Interview was used to collect data. Multivariable logistic regression was computed to assess factors associated with suicidal ideation and attempt. Result. Suicidal ideation and suicidal attempt were found to be 22.5% and 13.9%, respectively. WHO clinical stage of HIV, not being on HAART, depression, family history of suicidal attempt, and perceived stigma were associated with suicidal ideation. WHO clinical stage, being female, not being on HAART, use of substance, and depression were associated with suicidal attempt. Conclusion. Early diagnosis and treatment of opportunistic infections, depression, and early initiation of ART need to be encouraged in HIV-positive adults. Furthermore, counseling on substance use and its consequences and early identification of HIV-positive people with family history of suicidal ideation have to be considered.

Suicidal thoughts and behaviour among South African adolescents living with HIV: Can social support buffer the impact of stigma?

“…Almost half of the adolescents in this sample (44%) have experienced or perceived some level of HIV-related stigma, evidence of how pervasive this phenomenon still is. This study reinforces stigma as a risk factor for psychological distress and suicide among ALHIV: it identified both direct associations with suicide, in line with previous studies conducted with people living with HIV (Bitew et al, 2016;Gebremariam et al, 2017), as well as indirect effects mediated by depression.…”

“…Recent metaanalyses point to higher rates of depression, anxiety and emotional distress among people living with HIV who perceive more HIV-related stigma (Katz et al, 2013;Rueda et al, 2016); reviewed studies include longitudinal studies and randomised control trials. More specifically, HIV-related stigma has been associated with worse mental health among HIVpositive and HIV-affected youth, also in longitudinal analyses (Boyes and Cluver 2013;Cluver and Orkin, 2009;Dow et al, 2016;Pantelic et al, 2017), and with suicidal ideation and attempts among adults living with HIV (Bitew et al, 2016;Gebremariam et al, 2017). Links between poor mental health and suicide are well established, including among adolescents (Wild et al, 2004).…”

Suicidal ideation, psychopathology and associated factors among HIV-infected adults in Indonesia

“…In this study, we aim to identify suicidal ideation and psychopathology among PLHIV in Indonesia and the associated factors. Prior evidences in other countries signified depression as a major factor to the emergence of suicidal ideation among PLHIV [20,[39][40][41]. Thus, we hypothesize that Indonesian PLHIV who have experienced suicidal ideation will show significantly higher depression symptoms score.…”

“…Finally, lifetime suicidal ideation was recorded if the subjects responded with "yes" to the following question, "Have you ever seriously thought about committing suicide?" Similar method of assessment was done in other studies [8,20,42]. The question was taken from a section of World Mental Health-Composite International Diagnostic Interview (WMH-CIDI) suicidality assessment [43].…”

“…Prevalence in LMICs was similarly high, but resource limitation further added difficulties to the situation, due to underdiagnosis of mental disorders, suboptimal access to treatment, and limited research-based knowledge [18,19]. Subsequently, suicidal behavior was reported at an alarmingly high rate among PLHIV: 22.5% of PLHIV in Ethiopia showed suicidal ideation [20], increase in suicide rate due to HIV seropositive status was reported in South Africa (13.3 to 18.9%) [21], and suicidal ideation was reported in as many as 45% of HIV-positive men who have sex with men (MSM) in India [22]. High suicidal burden among PLHIV has been consistently reported across countries, highlighting the urgency to monitor associated factors to suicidal ideation [23].…”