Analysis Of Risk Factors For Suicide Ideation Among Newly Diagnosed HIV/AIDS Patients

Objectives On the basis of understanding the prevalence and risk factors of suicide ideation and suicide risk in newly diagnosed PLWHA,and combining with the previous literature to establish a path model.The path model was used to analyze the direct and indirect effects of the risk factors of suicide ideation and suicide risk in newly diagnosed PLWHA,which could provide a scientific evidence for the implementation of effective suicide intervention in newly diagnosed PLWHA,and developed a follow-up survey based on the cross-section study.Methods From November 2019 to November 2020,the newly diagnosed PLWHA was recruited from the HIV clinic of the center for disease prevention and control by convenience sampling.From December 2020 to January 2021,a semi-structured interview was conducted on the newly diagnosed PLWHA in the HIV clinic;and follow-up survey was conducted after the patient had confirmed HIV postive for 6 months.We use self-designed questionnaire and professional scale to investigate the suicide ideation,suicide risk and risk factor of newly diagnosed PLWHA.Descriptive analysis,chi-square test,t-test,and Logistic regression analysis were used to analyze the prevalence of suicidal ideation,suicidal risk and risk factors of newly diagnosed PLWHA.Spearman rank correlation,mediation analysis,and path model were used to analyze the direct and indirect effects of risk factors on suicidal ideation and suicidal risk.Nvivo 12.0 was used to analyze the result of interview.Results 1.Epidemiological characteristics of newly diagnosed PLWHA: This study received a total of 273 questionnaires,of which 263 were eligible questionnaires,and the eligibility rate of the questionnaires was 96.3%.Of the 263 newly diagnosed patients,96.2% were men,18-65 years of age,with a mean age of 31.8 ± 8.2 years;39.9% of patients had suicidal ideation,of which 25.7% of patients were at high risk of suicide;37.6% of patients thought have been deliberately transmitted and infected with HIV,and 57.0% of patients had a previous HIV self-test,including 70.7% of patients self-test was positive;24.7% of patients had high discrimination perception;51.7% of patients had low social support;46.8% of patients had low self-esteem;16.7% of patients had major anxiety,and 57.8% of patients had depression.2.Risk factors of suicide ideation among newly diagnosed PLWHA: The results of path model analysis showed that the effect of age on suicidal ideation was-0.151;being deliberately transmitted to cause HIV infection infection on suicidal ideation was 0.154;the effect of depression on suicidal ideation was 0.171;the effect of social support on suicidal ideation was-0.148;the effect of discrimination perception on suicidal ideation was 0.392.3.Risk factor of suicide risk among newly diagnosed PLWHA: Multivariate Logistic regression showed that the risk of suicide was higher among newly diagnosed PLWHA with depression(a OR=15.745,95%CI: 1.879-131.920),average monthly income lower than 4000 RMB.4.Risk factors for suicidal ideation in newly diagnosed PLWHA with different routes of transmission: Multiple Logistic regression analysis showed that knowing PEP(a OR=2.385,95%CI: 1.149-4.947),high discrimination(a OR=3.110,95%CI: 1.281-7.552),low level of social support(a OR=3.864,95%CI:1.265-11.806),depression(a OR=2.637,95%CI: 1.211-5.746)were risk factors for suicidal ideation in homosexual transmission patients.Being deliberately transmitted to cause HIV infection(a OR=5.564,95%CI: 1.533-20.200),moderate perception of discrimination(a OR=13.259,95%CI: 3.477-50.557),and high perception of discrimination(a OR=12.840,95%CI: 2.939-56.090)were risk factors for heterosexual transmission of newly diagnosed PLWHA suicidal ideation.5.Follow-up study of suicidal ideation among newly diagnosed PLWHA: patients were followed up 6 months after diagnosed,the follow-up patients was homogeneous with lost patients,and both periods resulted in significantly higher scores for social support and lower scores for self-esteem.The results showed that having a positive HIV self test(a OR=2.942,95% CI: 1.045-28.091),a negative HIV self test(a OR=13.101,95%CI: 1.823-94.147),and depression(a OR=11.046,95%CI: 2.451-49.790)6 months after diagosed were risk factors for suicidal ideation in patients.Conclusions 1.Newly diagnosed PLWHA predominantly young homosexual,most of the newly diagnosed PLWHA have had HIV self-test and the result of the self-test was postive was a risk factor of suicidal ideation among newly diagnosed PLWHA.2.The risk factors of suicidal ideation among newly diagnosed PLWHA were included individual factors,HIV infection factors,and mental health.Mental healths,especially discrimination,have the strongest effect on suicidal ideation among newly diagnosed PLWHA.Furthermore,newly diagnosed PLWHA thought they have been deliberately transmitted and infected with HIV was a strong positive effect on suicidal ideation.3.Low average monthly income and depression are risk factors for high suicide risk in newly diagnosed PLWHA.Therefore,we should strengthen the screening,surveilling,and intervention of suicide risk of newly diagnosis PLWHA with low income and depression.4.The difference in the prevalence of suicidal ideation among patients with different transmission routes was not statistically significant,and discrimination perception is a common risk factor for suicidal ideation among patients with different transmission routes,so that efforts should be focused on reducing discrimination experienced by patients in subsequent interventions for suicidal ideation.