More Than 1 in 3 With HIV, Depression Have Had Suicidal Thoughts

The global prevalence of suicidal ideation among people with human immunodeficiency virus (HIV) is 22.3%—and 36.4% among people with HIV and depression, suggests a systematic review and meta-analysis published in Psychosomatic Medicine.

“The findings suggest that people living with HIV have higher suicidality rates in the six World Health Organization (WHO) regions than the general population in the modern antiretroviral therapy era,” researchers wrote.

The study included 43 studies conducted in the WHO’s African region, region of the Americas, Southeast Asian region, European region, Eastern Mediterranean region, and the Western Pacific region between 2010 and 2021. Two-thirds of the studies were conducted within the last 5 years. More than 170,000 participants were included in the meta-regression analysis.

Pooled prevalence estimates were 22.3% for suicidal ideation, 9.6% for attempted suicide, and 1.7% for deaths by suicide among people with HIV, according to the study.

In addition to depression, factors that significantly increased the risk of suicidal ideation were substance use, poor quality of life, poor social support, without HIV status disclosure, living alone, without memory problems, family history of suicide, and HIV stage III.

Depression also increased the risk of suicide attempt, as did a family history of suicide. Significant risk factors for death by suicide were having a psychiatric disorder and involvement in studies in hospital settings, as opposed to national database studies or HIV clinic settings.

“Assessment of socioeconomic and psychological factors is recommended for further management to prevent suicide among people living with HIV,” researchers wrote. “The present findings are useful for design of intervention protocols and development of clinical practice guidelines intended to manage the well-being of people living with HIV worldwide.”

Reference:
Tsai YT, Padmalatha S, Ku HC, et al. Suicidality among people living with HIV from 2010 to 2021: a systematic review and a meta-regression. Psychosom Med. 2022;84(8):924-939. doi:10.1097/PSY.0000000000001127