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Wei L, Yan H, Guo M, Tian J, Jiang Q, Zhai M, Zhu B, Yin X, Liao Y, Yu B. Perceived HIV Stigma, Depressive Symptoms, Self-esteem, and Suicidal Ideation Among People Living with HIV/AIDS in China: a Moderated Mediation Modeling Analysis. J Racial Ethn Health Disparities 2023; 10:671-679. [PMID: 35165837 PMCID: PMC8853186 DOI: 10.1007/s40615-022-01255-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2021] [Revised: 01/03/2022] [Accepted: 01/18/2022] [Indexed: 12/04/2022]
Abstract
OBJECTIVE Suicidal ideation is an important public health challenge among people living with HIV (PLWH) across the world and in China. HIV stigma, depression, and self-esteem have been associated with suicidal ideation. However, the underlying mechanisms remain not fully understood. METHODS Study data were derived from a sample of 465 PLWH in China. Suicidal ideation after HIV diagnosis was used as outcome variable. HIV stigma, depressive symptoms, and self-esteem were measured using reliable instruments and used as predictor, mediator, and moderator, respectively. Mediation and moderated mediation model were used for data analysis. RESULTS 31.6% of PLWH in China had suicidal ideation after HIV diagnosis. The association between perceived HIV stigma and suicidal ideation was partially mediated by depression (indirect effect = 0.02, 95% CI = [0.02, 0.03]) with the path from perceived HIV stigma to depressive symptoms being moderated by self-esteem (interaction effect = - 0.02, 95% CI [- 0.03, - 0.01]). CONCLUSIONS Study findings suggested a mediation mechanism of HIV stigma on suicidal ideation through depressive symptoms, and self-esteem might weaken the mediation mechanism by moderating the perceived HIV stigma-depressive symptoms pathway.
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Affiliation(s)
- Liqing Wei
- School of Public Health, Wuhan University, Wuhan, 430072, China
| | - Hong Yan
- School of Public Health, Wuhan University, Wuhan, 430072, China.
| | - Menglan Guo
- School of Public Health, Wuhan University, Wuhan, 430072, China
| | - Jiawei Tian
- School of Public Health, Wuhan University, Wuhan, 430072, China
| | - Qingqing Jiang
- School of Public Health, Wuhan University, Wuhan, 430072, China
| | - Mengxi Zhai
- School of Public Health, Wuhan University, Wuhan, 430072, China
| | - Biao Zhu
- School of Public Health, Wuhan University, Wuhan, 430072, China
| | - Xiaohong Yin
- School of Public Health, Wuhan University, Wuhan, 430072, China
| | - Yu Liao
- School of Public Health, Wuhan University, Wuhan, 430072, China
| | - Bin Yu
- School of Public Health, Wuhan University, Wuhan, 430072, China
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Tsai YT, K. M. SP, Ku HC, Wu YL, Ko NY. Global overview of suicidal behavior and associated risk factors among people living with human immunodeficiency virus: A scoping review. PLoS One 2023; 18:e0269489. [PMID: 36940193 PMCID: PMC10029973 DOI: 10.1371/journal.pone.0269489] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2021] [Accepted: 05/22/2022] [Indexed: 03/21/2023] Open
Abstract
Death by suicide is a major public health problem. People living with human immunodeficiency virus (PLHIV) have higher risk of suicidal behavior than the general population. The aim of this review is to summarize suicidal behavior, associated risk factors, and risk populations among PLHIV. Research studies in six databases from January 1, 1988, to July 8, 2021, were searched using keywords that included "HIV," "suicide," and "risk factors." The study design, suicide measurement techniques, risk factors, and study findings were extracted. A total of 193 studies were included. We found that the Americas, Europe, and Asia have the highest rates of suicidal behavior. Suicide risk factors include demographic factors, mental illness, and physiological, psychological, and social support. Depression is the most common risk factor for PLHIV, with suicidal ideation and attempt risk. Drug overdosage is the main cause of suicide death. In conclusion, the current study found that PLHIV had experienced a high level of suicidal status. This review provides an overview of suicidal behavior and its risk factors in PLHIV with the goal of better managing these factors and thus preventing death due to suicide.
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Affiliation(s)
- Yi-Tseng Tsai
- Department of Nursing, An Nan Hospital, China Medical University, Tainan,
Taiwan
- Department of Nursing, College of Medicine, National Cheng Kung
University, Tainan, Taiwan
| | - Sriyani Padmalatha K. M.
- Department of Nursing, College of Medicine, National Cheng Kung
University, Tainan, Taiwan
- Operating Room Department, National Hospital of Sri Lanka, Colombo, Sri
Lanka
| | - Han-Chang Ku
- Department of Nursing, An Nan Hospital, China Medical University, Tainan,
Taiwan
- Department of Nursing, College of Medicine, National Cheng Kung
University, Tainan, Taiwan
| | - Yi-Lin Wu
- Department of Nursing, College of Medicine, National Cheng Kung
University, Tainan, Taiwan
| | - Nai-Ying Ko
- Department of Nursing, College of Medicine, National Cheng Kung
University, Tainan, Taiwan
- Department of Public Health, College of Medicine, National Cheng Kung
University, Tainan, Taiwan
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Hu F, Zhao D, Fu X, Zhang W, Tang W, Hu S, Shen W, Chen H. Gender differences in suicidal ideation, suicide attempts, and suicide death among people living with
HIV
: A systematic review and meta‐analysis. HIV Med 2022; 24:521-532. [PMID: 36347514 DOI: 10.1111/hiv.13435] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2022] [Accepted: 10/18/2022] [Indexed: 11/10/2022]
Abstract
OBJECTIVE Although excess mortality, especially suicide, is a critical trait in people living with HIV, consensus about gender differences in these areas is lacking. We conducted meta-analyses to examine gender differences in suicidal ideation, suicide attempts, and suicide death among people living with HIV. METHODS We systematically searched PubMed and Web of Science for studies written in English. In this review, suicide among people living with HIV includes suicide death, suicidal ideation, and suicide attempts. Studies reporting the suicide prevalence among males and females living with HIV were eligible for inclusion in our review. Odds ratios (ORs) and 95% confidence intervals (CIs) served as the effect size index. Fixed-effects or random-effects meta-analyses were chosen based on the size of the heterogeneity. RESULTS A total of 27 studies comprising 801 017 participants from 11 countries were included in the meta-analysis. The overall prevalence of suicidal ideation was 18.0% (95% CI 13.3%-22.8%) in males and 20.8% (95% CI 16.4%-25.1%) in females, and there was a statistically significant higher risk of suicidal ideation in females living with HIV (OR 1.30; 95% CI 1.09-1.56; p < 0.05). The overall prevalence of suicide attempts was 16.8% (95% CI 9.0%-24.5%) in males and 24.7% (95% CI 12.4%-37.1%) in females, and there was a statistically significant higher risk of suicide attempts in females living with HIV (OR 1.34; 95% CI 1.02-1.75; p < 0.05). The pooled prevalence of suicide death was 1.2% (95% CI 0.5%-1.9%) among males and 0.2% (95% CI 0.1%-0.3%) among females, and the risk of suicide death between genders was not statistically significant (OR 0.78; 95% CI 0.50-1.24; p = 0.298). CONCLUSIONS There were gender differences in suicidal ideation and suicide attempts among people living with HIV. Females living with HIV were more likely to experience suicidal ideation and make suicide attempts, but there were no statistically significant gender differences in suicide death. Appropriate initiatives to optimize the recognition, treatment, and management suicide behaviours of males and females living with HIV may narrow this gender gap.
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Affiliation(s)
- Fei‐Hong Hu
- School of Medicine Nantong University Nantong China
| | - Dan‐Yan Zhao
- School of Medicine Nantong University Nantong China
| | - Xue‐Lei Fu
- School of Medicine Nantong University Nantong China
| | | | - Wen Tang
- School of Medicine Nantong University Nantong China
| | - Shi‐Qi Hu
- School of Medicine Nantong University Nantong China
| | | | - Hong‐Lin Chen
- School of Public Health Nantong University Nantong China
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Fernandes H, Lima DV, Hino P, Taminato M, Okuno MFP. Self-inflicted violence and suicide in people living with HIV/AIDS: a systematic review. Rev Bras Enferm 2022; 75Suppl 3:e20210768. [PMID: 35703675 DOI: 10.1590/0034-7167-2021-0768] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2021] [Accepted: 02/03/2022] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVES to analyze intellectual productions on self-inflicted violence and suicide in people living with HIV/AIDS. METHODS a systematic review, carried out between March and April 2021, in the PubMed®/MEDLINE®, Web of Science and LILACS databases, subsidized in the Strengthening the Reporting of Observational Studies in Epidemiology. The period outlined was from 2011 to 2020. RESULTS a total of 199 studies were identified, and 16 composed the final sample, grouped into the categories: Sociodemographic characteristics of victims of self-inflicted violence/suicide and their intervening factors (pointing to young adults, especially homosexuals, with low social support and a history of mental illness or substance abuse as usual victims); Successful measures for suicide prevention/control in people living with HIV/AIDS (suggesting more frequent psychosocial and clinical follow-up of those starting antiretroviral and immunocompromised treatment). CONCLUSIONS biopsychosocial follow-up, analysis of sociodemographic profile and intervening factors should be frequent in this population for disease prevention/control.
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Affiliation(s)
- Hugo Fernandes
- Universidade Federal de São Paulo. São Paulo, São Paulo, Brazil
| | | | - Paula Hino
- Universidade Federal de São Paulo. São Paulo, São Paulo, Brazil
| | - Mônica Taminato
- Universidade Federal de São Paulo. São Paulo, São Paulo, Brazil
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HIV and Substance Use in Latin America: A Scoping Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19127198. [PMID: 35742448 PMCID: PMC9222977 DOI: 10.3390/ijerph19127198] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/29/2022] [Revised: 06/08/2022] [Accepted: 06/10/2022] [Indexed: 12/13/2022]
Abstract
This scoping review aims to explore the interplay between substance use (SU) and HIV in Latin America (LA). Database searches yielded 3481 references; 196 were included. HIV prevalence among people who used substances (PWUS) ranged from 2.8–15.2%. SU definitions were variable throughout studies, and thus data were not easily comparable. In 2019, only 2% of new HIV infections were attributed to injection drug use (IDU) in LA. Factors associated with HIV among PWUS included being female, IDU and homelessness, and PWUS were likely to engage in risky sexual behaviors, start antiretroviral treatment late, have poor adherence, have treatment failure, be lost to follow-up, have comorbidities, and experience higher mortality rates and lower quality of life, as has been reported in PLWH with SU in other regions. Five intervention studies were identified, and only one was effective at reducing HIV incidence in PWUS. Interventions in other regions have varying success depending on context-specific characteristics, highlighting the need to conduct more research in the LA region. Though progress has been made in establishing SU as a major concern in people living with HIV (PLWH), much more is yet to be done to reduce the burden of HIV and SU in LA.
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Fernandes H, Lima DV, Hino P, Taminato M, Okuno MFP. Violência autoprovocada e suicídio em pessoas que vivem com HIV/AIDS: revisão sistemática. Rev Bras Enferm 2022. [DOI: 10.1590/0034-7167-2021-0768pt] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
RESUMO Objetivos: analisar as produções intelectuais sobre a violência autoprovocada e suicídio em pessoas que vivem com HIV/AIDS. Métodos: revisão sistemática, realizada entre março e abril de 2021, nas bases PubMed®/MEDLINE®, Web of Science e LILACS, subsidiada no instrumento Strengthening the Reporting of Observational Studies in Epidemiology. O período delineado foi de 2011 a 2020. Resultados: identificaram-se 199 estudos, e 16 compuseram a amostra final, sendo agrupados nas categorias: Características sociodemográficas das vítimas de violência autoprovocada/suicídio e seus fatores intervenientes (apontando adultos jovens, especialmente homossexuais, com baixo suporte social e histórico de doenças mentais ou abuso de substâncias como as vítimas usuais); Medidas exitosas para prevenção/controle de suicídio em pessoas vivendo com HIV/AIDS (sugerindo acompanhamento psicossocial e clínico mais frequente daqueles em início de tratamento antirretroviral e imunodeprimidos). Conclusões: acompanhamento biopsicossocial, análise do perfil sociodemográfico e dos fatores intervenientes devem ser frequentes nesta população, para prevenção/controle do agravo.
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Affiliation(s)
| | | | - Paula Hino
- Universidade Federal de São Paulo, Brazil
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Hoare J, Sevenoaks T, Mtukushe B, Williams T, Heany S, Phillips N. Global Systematic Review of Common Mental Health Disorders in Adults Living with HIV. Curr HIV/AIDS Rep 2021; 18:569-580. [PMID: 34792706 PMCID: PMC8600343 DOI: 10.1007/s11904-021-00583-w] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/05/2021] [Indexed: 02/01/2023]
Abstract
PURPOSE OF THE REVIEW By reviewing the most recent common mental health disorders (CMHD) studies in people living with HIV (PLWH) (2018-2020), this review discusses the prevalence of CMHD, factors associated with CMHD in PLWH, mental health in PLWH from vulnerable groups, the impact of CMHD on HIV disease progression and adherence to antiretroviral therapy and the efficacy of different treatment approaches. RECENT FINDINGS After screening for eligibility 142 studies were included in the final systematic review. Only 27% of studies were conducted in Sub-Saharan Africa, which carries the highest burn of HIV disease globally. Despite the well-established increased risk of CMHD in PLWH, the current prevalence remains high, with studies reporting 28%-62% of PLWH having mental health symptoms. CONCLUSION Despite the significant challenges that CMHDs present to successful HIV treatment, there are many mental health treatments and interventions which can improve outcomes in PLWH and opportunities to task-shift and integrate mental health care with HIV care.
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Affiliation(s)
- Jacqueline Hoare
- Division of Liaison Psychiatry, Department of Psychiatry and Mental health, University of Cape Town, Anzio Road Observatory, Cape Town, 7925, South Africa.
- Faculty of Health Sciences, Penisula Medical School, University of Plymouth, Plymouth, UK.
| | - Tatum Sevenoaks
- Division of Liaison Psychiatry, Department of Psychiatry and Mental health, University of Cape Town, Anzio Road Observatory, Cape Town, 7925, South Africa
| | - Bulelwa Mtukushe
- Division of Liaison Psychiatry, Department of Psychiatry and Mental health, University of Cape Town, Anzio Road Observatory, Cape Town, 7925, South Africa
| | - Taryn Williams
- Division of Liaison Psychiatry, Department of Psychiatry and Mental health, University of Cape Town, Anzio Road Observatory, Cape Town, 7925, South Africa
| | - Sarah Heany
- Division of Liaison Psychiatry, Department of Psychiatry and Mental health, University of Cape Town, Anzio Road Observatory, Cape Town, 7925, South Africa
| | - Nicole Phillips
- Division of Liaison Psychiatry, Department of Psychiatry and Mental health, University of Cape Town, Anzio Road Observatory, Cape Town, 7925, South Africa
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Cecchini D, Alcaide ML, Rodriguez VDJ, Mandell LN, Abbamonte JM, Cassetti I, Cahn P, Sued O, Weiss SM, Jones DL. Women of Reproductive Age Living with HIV in Argentina: Unique Challenges for Reengagement in Care. J Int Assoc Provid AIDS Care 2020; 18:2325958219883250. [PMID: 31623511 PMCID: PMC6900676 DOI: 10.1177/2325958219883250] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
This study evaluated the reasons for not taking antiretroviral treatment (ART) among
women of reproductive age who are disengaged from HIV care (have missed pharmacy pickups
and physician visits), with the goal of identifying strategies for reengagement in HIV
care. Participants were cisgender women (n = 162), 18 to 49 years of age, and who
completed sociodemographic, medical history, reasons why they were not taking ART, mental
health, motivation, and self-efficacy assessments. Latent class analysis was used for
analysis. Women who reported avoidance-based coping (avoid thinking about HIV) had higher
depression (U = 608.5, z = −2.7, P =
.007), lower motivation (U = 601, z = −2.8,
P = .006), and lower self-efficacy (U = 644.5,
z = −2.4, P = .017) than those not using this
maladaptive strategy. As women living with HIV experience a disproportionate burden of
poor health outcomes, interventions focused on the management of depression may improve
HIV outcomes and prevent HIV transmission.
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Affiliation(s)
| | - Maria Luisa Alcaide
- Department of Medicine, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Violeta de Jesus Rodriguez
- Department of Psychology, University of Georgia, Athens, GA, USA.,Department of Psychiatry and Behavioral Sciences, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Lissa Nicole Mandell
- Department of Psychiatry and Behavioral Sciences, University of Miami Miller School of Medicine, Miami, FL, USA
| | - John Michael Abbamonte
- Department of Psychiatry and Behavioral Sciences, University of Miami Miller School of Medicine, Miami, FL, USA
| | | | - Pedro Cahn
- Fundacion Huesped, Buenos Aires, Argentina
| | - Omar Sued
- Fundacion Huesped, Buenos Aires, Argentina
| | - Stephen Marshall Weiss
- Department of Psychiatry and Behavioral Sciences, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Deborah Lynne Jones
- Department of Psychiatry and Behavioral Sciences, University of Miami Miller School of Medicine, Miami, FL, USA
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