HIV Center for Clinical and Behavioral Studies, New York State Psychiatric Institute and Columbia University, New York, NY.
Department of Psychiatry, Mental Health Data Science, Columbia University Medical Center, New York, NY.
J Acquir Immune Defic Syndr. 2021 Dec 1;88(4):348-355. doi: 10.1097/QAI.0000000000002784.
Suicide is a leading cause of death among adolescents and young adults (AYA). AYA living with perinatally acquired HIV infection (AYALPHIV) are at higher risk of attempted suicide when compared with AYA who were perinatally HIV-exposed but uninfected (AYAPHEU). To inform interventions, we identified risk and protective factors of attempted suicide among AYALPHIV and AYAPHEU.
Data were obtained from a longitudinal New York City-based study of AYALPHIV and AYAPHEU (n = 339; enrollment age 9-16 years) interviewed approximately every 12-18 months.
Our main outcome was suicide attempt at any follow-up. The DISC was used to assess psychiatric disorder diagnoses and attempted suicide and the Child Depression Inventory to assess depressive symptoms. Psychosocial and sociodemographic risk factors were also measured. Analyses used backward stepwise logistic regression modeling.
At enrollment, 51% was female individuals, 49% Black, 40% Latinx, and 11% both Black and Latinx. Attempted suicide prevalence was significantly higher among AYALPHIV compared with AYAPHEU (27% vs 16%, P = 0.019), with AYALPHIV having 2.21 times the odds of making an attempt [95% confidence interval: (1.18 to 4.12), P = 0.013]. Higher Child Depression Inventory scores were associated with an increased risk of attempted suicide in both groups and the total sample. The presence of DISC-defined behavior disorder increased the risk of attempted suicide in the total sample and the AYALPHIV subgroup. Religiosity was protective of attempted suicide in AYALPHIV.
AYALPHIV had increased suicide attempts compared with AYAPHEU. Religiosity was protective in AYALPHIV. Highlighting a need for prevention of early mental health challenges was associated with risk.
自杀是青少年和青年（AYA）人群的主要致死原因之一。与围产期 HIV 感染（AYALPHIV）的 AYA 相比，围产期 HIV 暴露但未感染（AYAPHEU）的 AYA 更有可能尝试自杀。为了提供干预依据，我们确定了 AYALPHIV 和 AYAPHEU 中自杀尝试的风险和保护因素。
数据来自于一项基于纽约市的 AYALPHIV 和 AYAPHEU 的纵向研究（n=339；入组年龄 9-16 岁），这些参与者大约每 12-18 个月接受一次访谈。
我们的主要结局是在任何随访中发生自杀未遂。使用 DISC 评估精神障碍诊断和自杀未遂情况，使用儿童抑郁量表评估抑郁症状。同时还测量了心理社会和社会人口学风险因素。分析采用向后逐步逻辑回归建模。
在入组时，51%是女性，49%是黑人，40%是拉丁裔，11%是黑人和拉丁裔。与 AYAPHEU 相比，AYALPHIV 的自杀未遂率显著更高（27%比 16%，P=0.019），AYALPHIV 尝试自杀的可能性是 AYAPHEU 的 2.21 倍[95%置信区间：（1.18 至 4.12），P=0.013]。在两个群体和总体样本中，儿童抑郁量表评分较高与自杀未遂风险增加相关。DISC 定义的行为障碍的存在增加了总样本和 AYALPHIV 亚组中自杀未遂的风险。宗教信仰在 AYALPHIV 中具有保护作用。
与 AYAPHEU 相比，AYALPHIV 自杀未遂的情况更多。宗教信仰在 AYALPHIV 中具有保护作用。强调早期心理健康挑战的预防必要性与风险相关。
