TY - JOUR PY - 2024// TI - Factors associated with suicidal ideation among people with HIV engaged in care JO - Journal of affective disorders A1 - Satre, Derek D. A1 - Sarovar, Varada A1 - Levine, Tory A1 - Leibowitz, Amy S. A1 - Lea, Alexandra N. A1 - Ridout, Kathryn A1 - Hare, C. Bradley A1 - Luu, Mitchell N. A1 - Flamm, Jason A1 - Dilley, James W. A1 - Davy-Mendez, Thibaut A1 - Sterling, Stacy A. A1 - Silverberg, Michael J. SP - ePub EP - ePub VL - ePub IS - ePub N2 - BACKGROUND: People with HIV (PWH) are at elevated risk for suicidal ideation (SI), yet few studies have examined how substance use, clinical and sociodemographic factors are associated with SI among PWH.

METHOD: We used substance use (Tobacco, Alcohol, Prescription Medication, and Other Substance Use [TAPS]) and depression (PHQ-9) data from computerized screening of adult PWH in primary care clinics in Northern California, combined with health record data on psychiatric diagnoses, HIV diagnosis, treatment, and control (HIV RNA, CD4), insurance, and neighborhood deprivation index (NDI) to examine factors associated with SI (PHQ-9 item 9 score > 0). Adjusted odds ratios (aOR) for SI were obtained from logistic regression models.

RESULTS: Among 2829 PWH screened (92 % male; 56 % white; mean (SD) age of 54 (13) years; 220 (8 %) reported SI. Compared with no problematic use, SI was higher among those reporting one (aOR = 1.65, 95 % CI = 1.17, 2.33), two (aOR = 2.23, 95 % CI = 1.42, 3.49), or ≥ 3 substances (aOR = 4.49, 95 % CI = 2.41, 8.39). SI risk was higher for those with stimulant use (aOR = 3.55, 95 % CI = 2.25, 5.59), depression (aOR = 4.18, 95 % CI = 3.04, 5.74), and anxiety diagnoses (aOR = 1.67, 95 % CI = 1.19, 2.34), or Medicaid (aOR = 2.11, 95%CI = 1.24, 3.60) compared with commercial/other insurance. SI was not associated with HIV-related measures or NDI. LIMITATIONS: SI was assessed with a single PHQ-9 item. Simultaneous SI and exposure data collection restricts the ability to establish substance use as a risk factor.

CONCLUSIONS: HIV care providers should consider multiple substance use, stimulant use, depression or anxiety, and public insurance as risk factors for SI and provide interventions when needed.

Language: en

LA - en SN - 0165-0327 UR - http://dx.doi.org/10.1016/j.jad.2024.05.036 ID - ref1 ER -