Correlates of suicidal ideation among HIV-positive persons

Columbia University, New York, New York, United States
AIDS (Impact Factor: 5.55). 06/2007; 21(9):1199-203. DOI: 10.1097/QAD.0b013e3281532c96
Source: PubMed

ABSTRACT The present investigation sought to determine the extent to which demographic characteristics, illness-related burdens, alcohol and other substance use, and psychosocial factors are independently associated with suicidal ideation in HIV-positive individuals.
HIV-positive individuals in four US cities (San Francisco, Los Angeles, Milwaukee, and New York City) were screened between July 2000 and January 2002 for recruitment into a randomized behavioral prevention trial. Utilizing data from this screening visit, rates and correlates of suicidal ideation were examined in a diverse sample of 2909 HIV-positive individuals.
Using binary logistic regression study sites, demographic characteristics, illness-related burdens, alcohol and substance use, and psychosocial factors were entered as predictors of suicidal ideation. This cross-sectional model thus examined the independent effects of each factor.
Approximately one-fifth (19%) of participants reported thoughts of suicide in the past week. We observed that participants who were not heterosexual, rated HIV-related symptoms and medication side effects as more severe, reported regular marijuana use, and described elevated affective symptoms of depression were those who were more likely to report suicidal ideation. Conversely, participants who identified as Hispanic/Latino, individuals in a primary romantic relationship, and those who reported greater self-efficacy for coping were less likely to report suicidal ideation.
Suicidal ideation among HIV-positive individuals is relatively common and is associated with multiple factors. These independent correlates may assist with identifying HIV-positive individuals who are at increased risk of suicidal ideation so that they may be assessed regularly and referred for psychological treatment when appropriate.

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    • "Persons with HIV commonly experience an overwhelming severity of symptoms from both the disease and HIV medications.(10) Major depression is the psychiatric disorder most associated with HIV infection(11) and, along with substance use disorders, is highly predictive of suicidal ideation in PLWH.(12) Sleep disturbance is another very common symptom, experienced by as many as 73% of persons with HIV. "
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    • "These independent correlates may assist identification of HIV-positive individuals whose risk of suicidal ideation is elevated. Accordingly, these persons can be assessed regularly and referred for psychological treatment where appropriate (Carrico et al., 2007). Endel obtained help: psychiatric during his depression and psychological in combating his pathological gambling; his dismissal from the army was a step-by-step process; he was given a civilian job. "
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    • "misuse precipitates suicidal behavior by adding stressful adverse effects, inducing depressed affect, and impairing problem solving skills through neurological and cognitive dysfunction. Likewise, Carrico et al. (2007) found that chronic marijuana use was predictive of suicidal ideation in adults with HIV. Substance use in this population may aggravate existing neurological and cognitive declines, and may result in fewer cognitive resources with which to compensate for and adapt to stressors. "
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