Citation

Tsai YT, K m SP, Ku HC, Wu YL, Yu T, Chen MH, Ko NY. Psychosom. Med. 2022; ePub(ePub): ePub.

Copyright

(Copyright © 2022, American Psychosomatic Society, Publisher Lippincott Williams and Wilkins)

DOI

10.1097/PSY.0000000000001127

PMID

36162070

Abstract

OBJECTIVE: The association between human immunodeficiency virus/ acquired immune deficiency syndrome (HIV/AIDS) and suicidality is not well understood, partly because of variability in results. This meta-analysis aimed to investigate the predictive value of HIV/AIDS for incident suicidality.

METHODS: A literature review was conducted of papers published between January 1, 2010, and October 31, 2021. The following databases were searched: Embase, MEDLINE, CINAHL, Web of Science, and Scopus. The search terms included HIV, suicidal behavior, auto mutilation, and self-injurious behavior. Observational studies were screened following a registered protocol, and eligible ones were meta-analyzed and followed by meta regression.

RESULTS: A total of 43 studies were included in this systematic review, and a meta-regression included 170,234 participants. The pooled prevalence estimates of suicidal ideation, attempted suicide, and deaths by suicide, were 22.3%, 9.6%, and 1.7%, respectively. The following significant risk factors for suicide ideation were found: substance use, depression, low quality of life, low social support, without HIV status disclosure, living alone, low level of memory problems, family history of suicide, and stage III of HIV. Risk factors for suicide attempts were depression, and family history of suicide. An elevated risk for suicide-related death was found for people living with HIH (PLHIV) who had a psychiatric disorder and in studies conducted in hospital-based settings (vs. national database studies or HIV clinic settings).

CONCLUSIONS: The risk of suicidality is high among PLHIV within all six WHO regions during the modern ART era. Assessment of socio-economic and psychological factors are recommended for further management to prevent suicide among PLHIV. The present findings are useful for design of intervention protocols and development of clinical practice guidelines intended to manage the wellbeing of PLHIV worldwide.

Language: en