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Hentzien M, Cabie A, Pugliese P, Billaud É, Poizot-Martin I, Duvivier C, Valantin MA, Kaladjian A, Dramé M, Bani-Sadr F. Factors associated with deaths from suicide in a French nationwide HIV-infected cohort. HIV Med 2018; 19:551-558. [PMID: 29856132 DOI: 10.1111/hiv.12633] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/13/2018] [Indexed: 12/27/2022]
Abstract
OBJECTIVES People living with HIV (PLHIV) are at a higher risk of dying by suicide than the general population. Epidemiological data regarding determinants of suicide in PLHIV are scarce. The aim of this study was thus to study demographic, socio-economic, psychiatric history and immunovirological characteristics associated with death from suicide in the French multicenter Dat'AIDS cohort, from January 2000 to July 2013. METHODS This was a nested case-control study. All deceased PLHIV during the study period who died by suicide and whose medical files could be checked were included as cases. Controls were selected using incidence density sampling. For each case, up to four controls were selected among all actively followed PLHIV at the index date (date of death of cases). Controls were matched for time from HIV diagnosis (5-year periods) and clinical centre. RESULTS Seventy cases and 279 controls were included in the study. By multivariable analysis, the factors significantly associated with death from suicide were: not having children, active or substituted drug consumption, alcohol intake > 20 g/day or history of alcohol abuse, history of depressive disorder and/or of attempted suicide, and psychotropic drug intake. Conversely, age, gender, country of birth, positive HCV serology and HIV-related factors, such as AIDS status, use of combination antiretroviral therapy (cART), nadir and current CD4 counts and HIV viral load, were not significantly associated with the risk of death from suicide. CONCLUSIONS In the cART era, HIV-related factors are not associated with a higher risk of suicide mortality. Suicide prevention measures should target PLHIV with the psychological morbidities observed in our cohort.
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Affiliation(s)
- M Hentzien
- Department of Internal Medicine, Clinical Immunology and Infectious Diseases, Reims University Hospital, University of Reims Champagne-Ardenne, Reims, France
| | - A Cabie
- Infectious and Tropical Diseases Unit, INSERM CIC1424, University Hospital of Martinique, Fort de France, France
| | - P Pugliese
- Department of Infectious Diseases, Nice University Hospital, Nice, France
| | - É Billaud
- Department of Infectious Diseases, Nantes University Hospital, Nantes, France
| | - I Poizot-Martin
- Immuno-Hematology Clinic, Marseille University Hospital, Marseille, France
- INSERM U912 (SESSTIM), Aix Marseille University, Marseille, France
| | - C Duvivier
- Assistance Publique des Hôpitaux de Paris, Necker Pasteur Center for Infectious Diseases and Tropical Medicine, IHU Imagine, Paris, France
| | - M-A Valantin
- Department of Infectious Diseases, Assistance Publique des Hôpitaux de Paris, Pitié-Salpêtrière Hospital, Paris, France
| | - A Kaladjian
- Department of Adult Psychiatry, Reims University Hospital, Reims, France
| | - M Dramé
- Department of Research and Public Health, Reims University Hospital, Reims, France
- Faculty of Medicine, EA 3797, University of Reims Champagne-Ardenne, Reims, France
| | - F Bani-Sadr
- Department of Internal Medicine, Clinical Immunology and Infectious Diseases, Reims University Hospital, University of Reims Champagne-Ardenne, Reims, France
- EA-4684/SFR CAP-SANTE, University of Reims Champagne-Ardenne, Reims, France
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Disclosure of HIV Status Beyond Sexual Partners by People Living with HIV in France: A Call for Help? Results from the National Cross-Sectional Survey ANRS-VESPA2. AIDS Behav 2017; 21:196-206. [PMID: 27614877 DOI: 10.1007/s10461-016-1549-9] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
HIV status disclosure remains a complex issue for most people living with HIV (PLWH). We analyzed PLWH disclosure behaviors in France, where treatment is free and where the social image of HIV has improved in the general population. Analyses focused on disclosure to the social network excluding sexual partners (close family, other relatives, friends, colleagues). The study sample comprised 3016 participants from the nationally representative survey ANRS-VESPA2. Three PLWH clusters were identified using hierarchical classification ("high disclosure level": 28.2 %, "medium disclosure level": 27.5 %, and "low disclosure level": 44.3 %). In multivariable analyses, the variable "not living in a couple but psychological social support needed" was independently associated with medium (AOR [95 % CI] 1.8 [1.4; 2.3]) and high levels of disclosure (1.4 [1.1; 1.8]) (multinomial regression models). For PLWH living alone, HIV status disclosure may reveal a need for psychological social support, a key component to treatment adherence and positive prevention.
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3
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Roux P, Lions C, Michel L, Vilotitch A, Mora M, Maradan G, Marcellin F, Spire B, Alain M, Patrizia CM. Concomitant use of benzodiazepine and alcohol in methadone-maintained patients from the ANRS-Methaville trial: Preventing the risk of opioid overdose in patients who failed with buprenorphine. Drug Alcohol Rev 2015. [DOI: 10.1111/dar.12329] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- Perrine Roux
- INSERM U912 (SESSTIM); Marseille France
- Aix-Marseille University; Marseille France
- ORS PACA (Regional Center for Disease Control - Provence-Alpes Côte d'Azur); Marseille France
| | - Caroline Lions
- INSERM U912 (SESSTIM); Marseille France
- Aix-Marseille University; Marseille France
- ORS PACA (Regional Center for Disease Control - Provence-Alpes Côte d'Azur); Marseille France
| | - Laurent Michel
- INSERM; Paris France
- University Paris-Sud and University Paris Descartes; Paris France
- Center Pierre Nicole; Paris France
| | - Antoine Vilotitch
- INSERM U912 (SESSTIM); Marseille France
- Aix-Marseille University; Marseille France
- ORS PACA (Regional Center for Disease Control - Provence-Alpes Côte d'Azur); Marseille France
| | - Marion Mora
- INSERM U912 (SESSTIM); Marseille France
- Aix-Marseille University; Marseille France
- ORS PACA (Regional Center for Disease Control - Provence-Alpes Côte d'Azur); Marseille France
| | - Gwenaelle Maradan
- INSERM U912 (SESSTIM); Marseille France
- Aix-Marseille University; Marseille France
- ORS PACA (Regional Center for Disease Control - Provence-Alpes Côte d'Azur); Marseille France
| | - Fabienne Marcellin
- INSERM U912 (SESSTIM); Marseille France
- Aix-Marseille University; Marseille France
- ORS PACA (Regional Center for Disease Control - Provence-Alpes Côte d'Azur); Marseille France
| | - Bruno Spire
- INSERM U912 (SESSTIM); Marseille France
- Aix-Marseille University; Marseille France
- ORS PACA (Regional Center for Disease Control - Provence-Alpes Côte d'Azur); Marseille France
| | | | - Carrieri M. Patrizia
- INSERM U912 (SESSTIM); Marseille France
- Aix-Marseille University; Marseille France
- ORS PACA (Regional Center for Disease Control - Provence-Alpes Côte d'Azur); Marseille France
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4
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Abstract
In the HIV-infected population there is a high prevalence of psychiatric disorders, conditions that often coexist with drug and alcohol dependence. Symptoms associated with psychiatric disorders are frequently managed with benzodiazepines, a class of medication often abused. We examined whether HIV-infected patients were more likely to fill a benzodiazepine prescription than their uninfected counterparts using a privately insured, nationally representative sample receiving clinical care between January 2007 and December 2009. Odds ratios (OR) and 95% confidence intervals (CI) to quantify the likelihood of receiving a benzodiazepine were calculated using multivariate logistic regression models. We examined the presence of interaction between HIV infection and sex using backwards elimination and by comparing stratum-specific OR to identify clinically meaningful differences. Overall, 323,796 beneficiaries were included in the sample, of which 723 were HIV infected. Bivariate analyses showed that compared to the uninfected sample, HIV-infected patients were more likely to have filled a benzodiazepine prescription (24% vs. 19%) during the study period. HIV-infected patients were also more likely to be male (80% vs. 44%), black (21% vs. 7%) and have a diagnosis of depression (12% vs. 8%) or insomnia (6% vs. 3%) than were uninfected patients. Adjusted for other covariates, HIV infection was associated with an increase (OR): 1.68, 95% CI: 1.39, 2.02) in the likelihood of filling a benzodiazepine prescription. When stratified by sex, HIV-infected males were more likely (OR: 1.68, 95% CI: 1.05, 2.67) than uninfected males to fill a benzodiazepine prescription while there was no observed difference in the likelihood of filling a benzodiazepine prescription between HIV-infected and uninfected females (OR: 1.12, 95% CI: 0.73, 1.70). Our findings suggest that HIV-infected patients, particularly HIV-infected males, are more likely to fill benzodiazepine prescriptions than their uninfected counterparts, highlighting the need for further research to investigate reasons for these observed differences.
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Affiliation(s)
- Sarah E Wixson
- a Department of Pharmacy Practice and Science , Institute for Pharmaceutical Outcomes and Policy, University of Kentucky , Lexington , KY , USA
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Torres TS, Cardoso SW, Velasque LDS, Marins LMS, Oliveira MSD, Veloso VG, Grinsztejn B. Aging with HIV: an overview of an urban cohort in Rio de Janeiro (Brazil) across decades of life. Braz J Infect Dis 2013; 17:324-31. [PMID: 23602466 PMCID: PMC9427395 DOI: 10.1016/j.bjid.2012.10.024] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2012] [Revised: 10/23/2012] [Accepted: 10/23/2012] [Indexed: 12/21/2022] Open
Abstract
The introduction of highly active antiretroviral therapy during the 1990s was crucial to the decline in the rates of morbidity and death related to the acquired immunodeficiency syndrome (AIDS) and turned human immunodeficiency virus (HIV) infection into a chronic condition. Consequently, the HIV/AIDS population is becoming older. The aim of this study was to describe the immunological, clinical and comorbidity profile of an urban cohort of patients with HIV/AIDS followed up at Instituto de Pesquisa Clinica Evandro Chagas, Oswaldo Cruz Foundation in Rio de Janeiro, Brazil. Retrospective data from 2307 patients during January 1st, 2008 and December 31st, 2008 were collected. For continuous variables, Cuzick's non-parametric test was used. For categorical variables, the Cochran–Armitage non-parametric test for tendency was used. For all tests, the threshold for statistical significance was set at 5%. In 2008, 1023 (44.3%), 823 (35.7%), 352 (15.3%) and 109 (4.7%) were aged 18–39, 40–49, 50–59 and ≥60 years-old, respectively. Older and elderly patients (≥40 years) were more likely to have viral suppression than younger patients (18–39 years) (p < 0.001). No significant difference in the latest CD4+ T lymphocyte count in the different age strata was observed, although elderly patients (≥ 50 years) had lower CD4+ T lymphocyte nadir (p < 0.02). The number of comorbidities increased with age and the same pattern was observed for the majority of the comorbidities, including diabetes mellitus, dyslipidemia, hypertension, cardiovascular diseases, erectile dysfunction, HCV, renal dysfunction and also for non-AIDS-related cancers (p < 0.001). With the survival increase associated to successful antiretroviral therapy and with the increasing new infections among elderly group, the burden associated to the diagnosis and treatment of the non-AIDS related HIV comorbidities will grow. Longitudinal studies on the impact of aging on the HIV/AIDS population are still necessary, especially in resource-limited countries.
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Affiliation(s)
- Thiago Silva Torres
- Fundação Oswaldo Cruz, Instituto de Pesquisa Clínica Evandro Chagas, HIV/AIDS Clinical Research Center, Rio de Janeiro, RJ, Brazil
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