Clinical correlates of suicidality among individuals with HIV infection and AIDS disease in Mbarara, Uganda

Abstract

The association between suicidality and HIV/AIDS has been demonstrated for three decades, but little is know about risk factors that can help understand this  association and help identify who is most at risk. Few research studies have been conducted in sub-Saharan Africa, a region that accounts for more than 70% of the HIV global burden. This paper describes clinical risk factors for suicidality among individuals with HIV infection and AIDS disease in Mbarara, Uganda. In this study, suicidality includes both suicidal ideation and suicidal attempts. A cross-sectional survey was conducted with 543 HIV-positive individuals aged 15 years and above, recruited from 2 HIV specialised clinics in Mbarara. Using logistic regression analysis, factors significantly associated with suicidality at 95% confidence interval were identified. The rate of suicidality was 10% (n = 54; 95% CI: 5.00–15.00). Risk factors for suicidality were: perception of poor physical health (OR 2.22, 95% CI 1.23–3.99, p = 0.007), physical pain (OR 1.83, 95% CI 1.01–3.30, p = 0.049), reducing work due to illness (OR = 2.22, 95% CI 1.23–3.99, p = 0.004) and recent HIV diagnosis (OR 1.02, 95% CI 1.01–1.03, p = 0.001). These findings suggest that HIV/AIDS in south-western Uganda is associated with a considerable burden of suicidality. HIV is associated with several clinical factors that increase vulnerability to suicidality. There is need for more appropriate interventions targeting these clinical risk factors, systematic suicide risk assessment and management of suicidal ideation and behaviours in HIV care.

Keywords: physical illness, risk factors, suicide, suicidal attempt, suicidal ideation, prevention