Gebrekidan Amanuel Yosef, Lombebo Afework Alemu, Efa Amelework Gonfa, Azeze Gedion Asnake, Kassie Gizachew Ambaw, Haile Kirubel Eshetu, Asgedom Yordanos Sisay, Woldegeorgis Beshada Zerfu, Dejenie Tadesse Asmamaw
School of Public Health, College of Health Sciences and Medicine, Wolaita Sodo University, Wolaita Sodo, Ethiopia.
School of Medicine, College of Health Sciences and Medicine, Wolaita Sodo University, Wolaita Sodo, Ethiopia.
Front Psychiatry. 2024 Sep 10;15:1361304. doi: 10.3389/fpsyt.2024.1361304. eCollection 2024.
Suicide is one of the main causes of mortality in the world, accounting for more fatalities than homicide, war, human immunodeficiency virus (HIV)/acquired immunodeficiency syndrome (AIDS), breast cancer, and malaria. Significantly, the biggest risk factors for suicide in the general population are having already attempted suicide and suicidal ideation. Despite the availability of studies on suicidal ideation among people living with HIV/AIDS (PLWHA) in Ethiopia, the results are inconsistent. Thus, a systematic review and meta-analysis was conducted to estimate the pooled prevalence of suicidal ideation among people living with HIV/AIDS.
A systematic review and meta-analysis was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guideline. To find papers published in the English language before 20 May 2023, the electronic databases of Medline, Science Direct, Excerpta Medica Database, Cochrane Library, African Journals Online (AJOL), and Google Scholar were searched. The DerSimonian and Laird method for random effects models was used to estimate the pooled prevalence of suicidal ideation with a 95% confidence interval in STATA V.14.0 statistical software. To test for heterogeneity between studies and publication bias, respectively, forest plots and funnel plots were used. Additionally, leave-one-out sensitivity was conducted.
A total of nine studies with 3,411 study participants were included in this systematic review and meta-analysis. The pooled prevalence of suicidal ideation among PLWHA was 20.55% (95% CI 14.76, 26.33). Being female (Odds ratio (OR) = 4.27, 95% CI = 2.29, 7.97), living alone (OR = 5.02, 95% CI = 2.15, 11.64), poor social support (OR = 3.80, 95% CI = 2.56, 5.65), perceived stigma (OR = 3.50, 95% CI = 1.55, 7.87), depression (OR = 5.08, 95% CI = 2.55, 11.48), undisclosed HIV status (OR = 4.8, 95% CI = 2.10, 10.93), and World Health Organization HIV clinical stages of III or IV (OR = 4.40, 95% CI = 2.95, 6.58) were significantly associated with suicidal ideation.
Suicidal ideation among PLWHA is high in Ethiopia. Therefore, emphasis should be given to psychiatric assessment and interventions with a special focus on individuals having the associated factors.
PROSPERO (CRD42023429613).
自杀是全球主要死因之一，其致死人数超过凶杀、战争、人类免疫缺陷病毒（HIV）/获得性免疫缺陷综合征（AIDS）、乳腺癌和疟疾。值得注意的是，普通人群中自杀的最大风险因素是曾有自杀未遂经历和自杀意念。尽管埃塞俄比亚有关于HIV/AIDS感染者（PLWHA）自杀意念的研究，但结果并不一致。因此，进行了一项系统评价和荟萃分析，以估计PLWHA中自杀意念的合并患病率。
按照系统评价和荟萃分析的首选报告项目（PRISMA）指南进行系统评价和荟萃分析。为查找2023年5月20日前发表的英文论文，检索了Medline、Science Direct、医学文摘数据库、Cochrane图书馆、非洲期刊在线（AJOL）和谷歌学术等电子数据库。采用DerSimonian和Laird随机效应模型方法，在STATA V.14.0统计软件中估计自杀意念的合并患病率及95%置信区间。分别使用森林图和漏斗图检验研究间的异质性和发表偏倚。此外，还进行了逐一剔除敏感性分析。
本系统评价和荟萃分析共纳入9项研究，3411名研究参与者。PLWHA中自杀意念的合并患病率为20.55%（95%CI 14.76，26.33）。女性（优势比（OR）=4.27，95%CI=2.29，7.97）、独居（OR=5.02，95%CI=2.15，11.64）、社会支持差（OR=3.80，95%CI=2.56，5.65）、感知到耻辱感（OR=3.50，95%CI=1.55，7.87）、抑郁（OR=5.08，95%CI=2.55，11.48）、未公开HIV感染状况（OR=4.8，95%CI=2.10，10.93）以及世界卫生组织HIV临床分期为III或IV期（OR=4.40，95%CI=2.95，6.58）与自杀意念显著相关。
埃塞俄比亚PLWHA的自杀意念发生率较高。因此，应重视精神科评估和干预，尤其关注具有相关因素的个体。
PROSPERO（CRD42023429613）
