Prevalence and risk factors for youth suicidality among perinatally infected youths living with HIV/AIDS in Uganda: the CHAKA study.

Journal: Child and adolescent psychiatry and mental health

Volume: 14

Issue: 

Year of Publication: 

Affiliated Institutions:  Department of Psychiatry, Mbarara University of Science and Technology, Mbarara, Uganda. Statistical Section, MRC/UVRI and LSHTM Uganda Research Unit, Entebbe, Uganda. Department of Psychiatry, Stony Brook University, Stony Brook, New York, USA. Department of Global Health and Social Medicine, Harvard Medical School, Massachusetts, USA. MRC/UVRI and LSHTM Uganda Research Unit, Mental Health Project, Entebbe, Uganda.

Abstract summary 

Research from high income countries indicates that suicide is a major mental health care concern and a leading cause of preventable deaths among children and adolescents. Proper assessment and management of youth suicidality is crucial in suicide prevention, but little is known about its prevalence and associated risk factors in Sub-Saharan Africa. In low income countries there is an increased risk of suicide among persons with HIV/AIDS even in the presence of the highly active antiretroviral therapy.To determine the prevalence of and risk factors for youth suicidality among perinatally infected youth living with HIV/AIDS in Uganda.We studied 392 HIV positive children (5-11 years) and adolescents (12-17 years) and their caregivers in Kampala and Masaka districts. Caregivers were administered the suicide assessment section of the MINI International Psychiatric Interview. Socio-demographic characteristics, psychiatric diagnoses, and psychosocial and clinical factors were assessed and suicidality (suicidal ideation and or suicidal attempt) was the outcome variable. Logistic regression was used to calculate odds ratios adjusting for study site and sex at 95% confidence intervals.Caregivers reported a suicidality rate of 10.7% (CI 8-14.1) in the past one month with higher rates among urban female (12.4%, CI 8.6-17.7) than male (8.7%, CI 5.4-13.8) youth. Lifetime prevalence of attempted suicide was 2.3% (n = 9, CI 1.2-4.4) with the highest rates among urban female youth. Among children, caregivers reported a lifetime prevalence of attempted suicide of 1.5%. The self-reported rate of attempted suicide in the past month was 1.8% (n = 7, CI 0.8-3.7) with lifetime prevalence of 2.8% (n = 11, CI 1.6-5.0). The most common methods used during suicide attempts were cutting, taking overdose of HIV medications, use of organophosphates, hanging, stabbing and self-starvation. Clinical correlates of suicidality were low socioeconomic status (OR = 2.27, CI 1.06-4.87, p = 0.04), HIV felt stigma (OR = 2.10, CI 1.04-3.00, p = 0.02), and major depressive disorder (OR = 1.80, CI 0.48-2.10, p = 0.04). Attention-deficit/hyperactivity disorder was protective against suicidality (OR = 0.41, CI 0.18-0.92, p = 0.04).The one-month prevalence of suicidality among CA-HIV was 10.7%.

Authors & Co-authors:  Rukundo Godfrey Zari GZ Mpango Richard Stephen RS Ssembajjwe Wilber W Gadow Kenneth D KD Patel Vikram V Kinyanda Eugene E

Study Outcome 

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Statistics
Citations :  Wasserman D, Cheng Q, Jiang GX. Global suicide rates among young people aged 15-19. World Psychiatr. 2005;4(2):114–120.
Authors :  6
Identifiers
Doi : 41
SSN : 1753-2000
Study Population
Male,Female
Mesh Terms
Other Terms
HIV;Suicidal attempt;Suicidal ideation;Suicidality;Suicide;Youths
Study Design
Cross Sectional Study
Study Approach
Country of Study
Uganda
Publication Country
England