Department of Psychiatry, University of Gondar, Gondar, Ethiopia.
Amanuel Mental Specialized Hospital, Addis Ababa, Ethiopia.
PLoS One. 2019 Nov 5;14(11):e0224371. doi: 10.1371/journal.pone.0224371. eCollection 2019.
Suicide which is considered a psychiatric emergency, is a serious cause of mortality worldwide. Youth living with HIV/AIDS (YLWHA) have higher rates of suicidal behavior than the general public. This study aimed to assess the magnitude and associated factors of suicide ideation and attempt among the Human Immune deficiency Virus (HIV) positive youth attending anti-retroviral therapy (ART) follow up at St. Pauls hospital Millennium Medical College and St. Peters specialized hospital, Addis Ababa, Ethiopia.
In this cross-sectional study, 413 HIV positive youth were recruited for interviews, using the systematic random sampling technique. The Composite International Diagnostic Interview (CIDI) was used to assess suicide. PHQ-9, the Oslo social support and HIV perceived stigma scale instruments were used to assess the factors. We computed bivariate and multivariable binary logistic regressions to assess factors associated with suicidal ideation and attempt. Statistical significance was declared at P-value <0.05.
The magnitude of suicidal ideation and attempts were found to be 27.1% and 16.9%, respectively. In the multivariate analysis, female sex (adjusted odd ratio(AOR) = 3.1, 95% CI, 1.6-6.0), family death (AOR = 2.1, 95%CI 1.15-3.85), WHO clinical stage III of HIV (AOR = 3.1 95% CI 1.3-7.35), WHO clinical stage IV of HIV (AOR = 4.76, 95%CI, 1.3-7.35), co-morbid depression (AOR = 7.14, 95%CI, 3.9-12.9), and perceived HIV stigma (AOR = 4.2, 95%CI, 2.27-8.2) were significantly associated with suicidal ideation, whereas female sex (AOR = 4.12, 95%CI, 1.82-9.78), opportunistic infections (AOR = 3.1, 95%CI, 1.6-6.04), WHO clinical stage III of HIV (AOR = 3.1 95%CI 1.24-7.81), co-morbid depression (AOR = 5.6 95% CI, 2.8-11.1), and poor social support (AOR = 3.4, 95%CI, 1.2-9.4) were statistically significant with suicidal attempt. The result suggests that the magnitude of suicidal ideation and attempts among HIV positive youth were high. We recommend that clinicians consider youth with comorbid depression, perceived HIV stigma and poor social support.
自杀被认为是一种精神科急症，是全球范围内导致死亡的一个严重原因。与普通公众相比，感染艾滋病毒的青年（YLWHA）的自杀行为发生率更高。本研究旨在评估在埃塞俄比亚亚的斯亚贝巴圣保禄医院千年医药学院和圣彼得专门医院接受抗逆转录病毒治疗（ART）随访的艾滋病毒阳性青年中，自杀意念和尝试的程度及相关因素。
在这项横断面研究中，采用系统随机抽样技术，对 413 名艾滋病毒阳性青年进行了访谈。采用复合国际诊断访谈（CIDI）评估自杀情况。使用 PHQ-9、奥斯陆社会支持和艾滋病毒感知耻辱量表评估因素。我们计算了双变量和多变量二元逻辑回归，以评估与自杀意念和尝试相关的因素。P 值<0.05 表示具有统计学意义。
自杀意念和尝试的发生率分别为 27.1%和 16.9%。在多变量分析中，女性（调整后的优势比[OR] = 3.1，95%CI，1.6-6.0）、家庭死亡（OR = 2.1，95%CI 1.15-3.85）、艾滋病毒临床分期 III（OR = 3.1，95%CI 1.3-7.35）、艾滋病毒临床分期 IV（OR = 4.76，95%CI，1.3-7.35）、合并抑郁（OR = 7.14，95%CI，3.9-12.9）和感知艾滋病毒耻辱感（OR = 4.2，95%CI，2.27-8.2）与自杀意念显著相关，而女性（OR = 4.12，95%CI，1.82-9.78）、机会性感染（OR = 3.1，95%CI，1.6-6.04）、艾滋病毒临床分期 III（OR = 3.1，95%CI 1.24-7.81）、合并抑郁（OR = 5.6，95%CI，2.8-11.1）和社会支持差（OR = 3.4，95%CI，1.2-9.4）与自杀尝试具有统计学意义。结果表明，艾滋病毒阳性青年的自杀意念和尝试发生率较高。我们建议临床医生考虑合并抑郁、感知艾滋病毒耻辱感和社会支持差的青年。
