Effect of suicidality on clinical and behavioural outcomes in HIV positive adults in Uganda.

Journal: PloS one

Volume: 16

Issue: 8

Year of Publication: 2021

Affiliated Institutions:  Department of Psychiatry, Mbarara University of Science and Technology, Mbarara, Uganda. School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa. Mental Health Project, MRC/UVRI and LSHTM Uganda Research Unit, Entebbe, Uganda. Department of Global Health and Social Medicine, Harvard Medical School, Boston, Massachusetts, United States of America.

Abstract summary 

Suicidality is a risk of a person committing suicide often characterized by suicidal ideation, intent or attempts. Despite the high burden of suicidality among individuals living with HIV and HAIDS, there is paucity of data on the impact of suicidality on clinical (such as CD4 counts and HIV disease progression) and behavioural outcomes (such as adherence to HIV Medications). Cross-sectional investigations of these associations are often complicated by bidirectional causal relationships and hence the need for longitudinal study designs. We conducted a cohort study to determine the impact of suicidality on clinical and behavioural outcomes among adults living with HIV/AIDS in Uganda.We conducted the study among 1099 ART naïve adults living with HIV/AIDS in Uganda. Data were collected at three time points: baseline, 6 and 12 months. Multiple regression and discrete time survival models were used to determine the relationship between suicidality and indices of HIV outcomes.Majority of the participants were female and the participant mean age was 35 years. Most of them (73%) had primary or no formal education. The proportion of participants with suicidality decreased from 2.9% at baseline to roughly 1% both at month 6 and month 12. Of the investigated clinical and behavioural outcomes, baseline suicidality only had a negative impact on missing a dose of ART where the odds of missing a dose of ART were 8.25 (95% CI 2.45-27.71, p>0.01) times higher for participants with suicidality compared to those without suicidality. The following outcomes were not significantly impacted by baseline suicidality: HIV clinical stage, CD4 count and risky sexual behaviour.The fact that baseline suicidality significantly negatively impacted ART adherence calls for the incorporation of psychosocial interventions to target indices of psychological distress such as suicidality to improve HIV related outcomes.

Authors & Co-authors:  Rukundo Godfrey Zari GZ Levin Jonathan J Mpango Richard Stephen RS Patel Vikram V Kinyanda Eugene E

Study Outcome 

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Citations :  Klonsky ED, May AM, Saffer BY. Suicide, Suicide Attempts, and Suicidal Ideation. Annu Rev Clin Psychol. 2016;12:307–30. doi: 10.1146/annurev-clinpsy-021815-093204
Authors :  5
Identifiers
Doi : e0254830
SSN : 1932-6203
Study Population
Female
Mesh Terms
Adolescent
Other Terms
Study Design
Cohort Study,Longitudinal Study,,Cross Sectional Study
Study Approach
Country of Study
Uganda
Publication Country
United States