An Epidemiologic Study On Attempted Suicide Among People Living With HIV/AIDS

Objective: This study was designed to explore the occurrence, the timing of onset distribution and risk factors of attempted suicide among people living with HIV/AIDS in order to provide scientific evidence for initiating suicide prevention for HIV-positive persons.Methods: One hundred ninety-five HIV-positive persons who lived in Yangjiang city and Zhongshan city completed a questionnaire by a face-to-face interview that obtained information about sociodemographic data, suicide attempted, HIV infected related factors and the time of onset of drug use, first HIV-positive notification, AIDS diagnosis and suicide attempt(s). The time course for each subject was divided into 4 stages, namely prior to HIV notification, in first 6 months after HIV notification but prior to AIDS diagnosis, more than 6 months after HIV notification but prior to AIDS diagnosis, and after AIDS diagnosis. The rates of attempted suicide (per 1000 person-year) in each stage were compared. Life-table analysis was used to examine time of onset distribution of attempted suicide. Risk factors are examined using Cox proportional hazard regression model.Results: Lifetime prevalence of attempted suicide and suicidal ideation was 19.49% (38/195) and 40.51% (79/195), respectively. The 12-month prevalence of attempted suicide was 6.67% (13/195). Of the 38 attempters, 63.17% (24/38) had committed the first attempt after HIV-positive notification. The occurrence of attempted suicide was significantly higher after known of HIV-infection (χ2=4.01,P<0.05). The survival curve showed that the cumulative survival rate of attempted suicide decreased faster after HIV-infection than prior of HIV-infection (χ2=45.71, P<0.001). The risk of suicide attempt was increased significantly with advancing disease (Z=23.52,P<0.0001). After HIV-positive notification, AIDS was the main reason for suicide, 55.81% of suicide caused by HIV-infected, and over 50% of the attempters purposed suicide to free from suffering. The hazard curve of attempted suicide after HIV-infection was bimodal distribution, elevated risk for suicide attempted within the second year and the sixth-seventh year after HIV-positive notification. Cox regression analysis showed that HIV-infection was significantly related to attempted suicide [RR(95%CI): 8.34(4.05~17.09)]. After adjusted for drug use, HIV-infection was also correlated with suicide attempt, adjusted RR(95%CI): 7.20(3.52~14.75). Multivariate Cox regression analysis showed that experienced discrimination was the risk factor for suicide attempt.Conclusions: People with HIV/AIDS appear to have a significantly increased risk for attempted suicide, suggesting a need to arise awareness of suicidality among people living with HIV/AIDS, and develop a psychological crisis evaluation programme for them in HIV voluntary counseling and testing clinic. It should make further research on the cause of suicidal behavior and take effective measures to prevent suicide among people living with HIV/AIDS.