Abstract
BackgroundSuicide is a leading cause of death among men who have sex with men (MSM) and suicidal ideation may put individuals at higher risk of suicide. A great disparity of lifetime prevalence of suicidal ideation among MSM was observed across studies, indicating the importance of a reliable estimation of the pooled lifetime prevalence. However, the only one published meta-analysis estimating the pooled lifetime prevalence of suicidal ideation among MSM was conducted in 2008 with only 2 eligible studies. Subsequently, there was a rapid increase of publications about lifetime suicidal ideation among MSM, suggesting that an update on the pooled lifetime prevalence of suicidal ideation among MSM was necessary. Therefore, this study aimed to update the estimation of the pooled lifetime prevalence of suicidal ideation among MSM.MethodsElectronic databases of PubMed, CINAHL, Scopus (social science), Embase and PsycInfo were searched until September 2017 to identify relevant studies. Cross-sectional studies exploring the lifetime prevalence of suicidal ideation among MSM were enrolled. Heterogeneity was evaluated using the Cochran Q test and quantified using the I2 statistic. The possibility of publication bias was assessed using both Begg’s rank test and Egger’s linear test, and an Egger’s funnel plot for asymmetry was presented. Subgroup analyses were performed according to the geographic area, sample source and HIV status.ResultsNineteen studies with a total of 26,667 MSM were included, of which 9374 were identified with suicidal ideation. A high degree of heterogeneity (P ≤ 0.001, I2 =99.2%) was observed among the eligible studies, with the reported prevalence ranging from 13.18 to 55.80%. The pooled lifetime prevalence of suicidal ideation among MSM by a random effects model was 34.97% (95% confidence interval: 28.35%–41.90%). Both the Begg’s rank test and Egger’s linear test indicated low possibility of publication bias. Subgroup analyses showed that the lifetime prevalence of suicidal ideation among MSM differed significantly by geographic area, sample source and HIV status (P < 0.05).ConclusionsThe high pooled lifetime prevalence of suicidal ideation among MSM found in this meta-analysis significantly underscores the importance of early assessment of suicidal ideation among MSM, as well as the need for strengthening the psychological interventions.
Highlights
Suicide is a leading cause of death among men who have sex with men (MSM) and suicidal ideation may put individuals at higher risk of suicide
Compared with heterosexual males, MSM are at higher risk for suicidal ideation [8, 9], which may be associated with the discrimination and stigma brought by their sexual orientation [8, 10, 11]
The pooled lifetime prevalence of suicidal ideation among MSM found in this study (34.97%) was much higher than that among general population found in previous meta-analyses (3.9–11.5%) [35,36,37,38], and higher than the lifetime prevalence of suicidal ideation among lesbians found in some previous studies
Summary
Suicide is a leading cause of death among men who have sex with men (MSM) and suicidal ideation may put individuals at higher risk of suicide. There was a rapid increase of publications about lifetime suicidal ideation among MSM, suggesting that an update on the pooled lifetime prevalence of suicidal ideation among MSM was necessary. In a worldwide population-based study, Mathy found that MSM in South America, North America and Asia were at 7.5, 2.1 and 2.9 times higher risk for suicidal ideation than heterosexual males, respectively [12]. Based on these findings, the assessment of suicidal ideation is imperative among MSM
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