Govender R D, Schlebusch L
Department of Family Medicine, University of Kwa-Zulu Natal, Nelson R Mandela School of Medicine, Durban, South Africa.
Afr J Psychiatry (Johannesbg). 2012 Mar;15(2):94-8. doi: 10.4314/ajpsy.v15i2.12.
Suicidal behaviour and HIV/AIDS are significant public health concerns. The aim of this study was to investigate suicidal ideation in patients who were referred to a voluntary HIV counselling and testing (VCT) clinic and who were found to be seropositive. This in order to improve suicide prevention and intervention strategies amongst such patients.
The sample studied consisted of volunteer adult patients referred over a three-month period to a HIVVCT clinic based at a university-affiliated general state hospital. Patients completed a questionnaire on sociodemographic data. Suicidal ideation was measured using the Beck Hopelessness Scale and the Beck Depression Inventory (BDI), at two time points (within 72 hours after notification and again at a 6 week follow-up). All patients received extensive pre-and post-test counselling.
HIV-test results were available for 189 (99.5%) of the original sample of 190 patients studied, with 157 (83.1%) testing positive. More females tested positive as did unemployed and single/divorced patients. The mean age for HIV-positive patients was 33.49 (SD = 9.449), and for HIV-negative patients it was 37.94 (SD = 15.238). Age was a significant factor in that for each year increase in age, the risk of testing HIV-positive decreased by 4.1%. Lower education and traditional beliefs were also significantly associated with testing HIV-positive. At 72 hours suicidal ideation was present in 17.1% (95% confidence interval 12.16% to 23.45%), and at 6 weeks in 24.1% (95% confidence interval 17.26% to 32.39%) of the seropositive patients. Their average BDI scores were 15.20 and 14.23 respectively at the two time points.
Suicidal ideation was present in a significant number of the seropositive cohort studied and increased over a six week period among these patients. The average BDI scores at both time points imply a clinical depression. The findings also suggest an association between positive HIV-test results and certain socio-demographic variables that can act as indicators for suicidal ideation in HIV-infected persons, although this requires further research. Although the relationship between suicidal ideation and HIV-infection is complex, it is an important consideration when assessing patient suicide vulnerability at HIV VCT clinics and when implementing suicide prevention and management strategies.
自杀行为和艾滋病毒/艾滋病是重大的公共卫生问题。本研究的目的是调查被转诊至自愿性艾滋病毒咨询与检测（VCT）诊所且血清学检测呈阳性的患者的自杀意念。以便改善此类患者的自杀预防和干预策略。
研究样本包括在三个月期间转诊至一家隶属于大学的州立综合医院的艾滋病毒VCT诊所的成年志愿者患者。患者完成了一份关于社会人口学数据的问卷。使用贝克绝望量表和贝克抑郁量表（BDI）在两个时间点（通知后72小时内以及6周随访时）测量自杀意念。所有患者在检测前后均接受了广泛的咨询。
在研究的190名患者的原始样本中，有189名（99.5%）获得了艾滋病毒检测结果，其中157名（83.1%）检测呈阳性。女性、失业者以及单身/离婚患者检测呈阳性的比例更高。艾滋病毒阳性患者的平均年龄为33.49岁（标准差=9.449），艾滋病毒阴性患者的平均年龄为37.94岁（标准差=15.238）。年龄是一个重要因素，即年龄每增加一岁，艾滋病毒检测呈阳性的风险降低4.1%。低教育水平和传统观念也与艾滋病毒检测呈阳性显著相关。在72小时时，17.1%（95%置信区间为12.16%至23.45%）的血清学阳性患者有自杀意念，在6周时这一比例为24.1%（95%置信区间为17.26%至32.39%）。在这两个时间点，他们的平均BDI得分分别为15.20和14.23。
在所研究的血清学阳性队列中，相当数量的患者存在自杀意念，且在这些患者中这一比例在六周内有所上升。两个时间点的平均BDI得分均表明存在临床抑郁。研究结果还表明艾滋病毒检测阳性结果与某些社会人口学变量之间存在关联，这些变量可作为艾滋病毒感染者自杀意念的指标，不过这需要进一步研究。尽管自杀意念与艾滋病毒感染之间的关系很复杂，但在艾滋病毒VCT诊所评估患者自杀易感性以及实施自杀预防和管理策略时，这是一个重要的考虑因素。
