Featured news from NHIVNA
HIV-related news from NAM
Suicide accounts for 2% of deaths in people with HIV, twice the rate of the general population
Roger Pebody, 2017-04-06 22:50:00
Men living with HIV have an elevated rate of suicide,
particularly in the first year after diagnosis, according to a fifteen-year
study of almost 90,000 people diagnosed with HIV in England and Wales, with
comparison against the general population. Sara Croxford of Public Health
England presented the findings to the British HIV Association (BHIVA) conference in
“Our findings highlight the need for a reduction in the
stigma surrounding HIV, improvements in psychosocial support and routine
screening for depression and drug and alcohol misuse, particularly at the time
of diagnosis,” she said.
Suicide has figured as a cause of death in numerous previous
studies of people with HIV. Furthermore, high rates of depression, anxiety and
suicidal thoughts have been seen in numerous cohorts and surveys.
The study draws on a comprehensive national cohort of all
88,994 people diagnosed with
HIV in England and Wales between 1997 and 2012. These data were linked to the Office of National
Statistics’ death data, using pseudo-anonymised identifiers. Deaths reported by
HIV clinicians were also included.
By the end of 2012, deaths had been recorded in 6% of the
cohort (5302 people), representing an all-cause mortality rate of 118 per 10,000 person years. The death rate
was six times greater in people with HIV than in the general population. Delays
in testing, linkage to care, and treatment were the major factors that
contributed to this increased mortality.
The most important cause of death was AIDS-defining
illnesses (58%), almost always in individuals who were diagnosed very late.
Over half of those who died of AIDS had never attended HIV clinical care or had
never taken HIV treatment.
Other causes of death included cancers (8%), cardiovascular
disease or stroke (8%), infections (8%), liver disease (5%), substance misuse
(3%) and suicide (2%).
Looking into the 96 deaths from suicide in more detail, 91 occurred
in men, with similar rates in gay and heterosexual men. Rates were elevated in
injecting drug users, compared to other groups.
Women’s suicide rates were not higher than those in the
Comparing rates of suicide in men with HIV to rates in men
in the general population of the same age (expressed through standardised
mortality rates or SMRs), the rate was double that of the general population
Four in ten suicides occurred in the first year after
diagnosis. During this time, men’s suicide rate was five times that of the
general population (SMR 5.3).
There was no evidence of a fall in suicides over the study
period, 1997 to 2012. Suicides occurred both in people linked and not linked to
care, and in people on and off treatment.
While the researchers do not have data on social or
behavioural factors that might explain the findings, the particularly high rate
of suicide in the first year of an HIV diagnosis suggests that stigma,
difficulties adapting to the diagnosis, insufficient mental health provision
and a lack of support services contribute to suicide.