Psychosocial health and suicidal ideation among people living with HIV/AIDS: A cross-sectional study in Nanjing, China.

Wei Wang,Yinmei Yang,Hong Yan,Chenchang Xiao,Shiyue Li,Xing Yao,Robert K Heaton

doi:10.1371/journal.pone.0192940

Wei Wang, Yinmei Yang + Show 5 more

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https://doi.org/10.1371/journal.pone.0192940

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Abstract

BackgroundSuicide is a serious cause of mortality worldwide and is considered as a psychiatric emergency. People living with HIV/AIDS (PLWHA) have higher rates of suicidal behavior than the general population. This study assessed the prevalence and verified the syndemic effect of psychosocial health conditions on suicidal ideation among PLWHA in China.MethodsAn institutional-based cross-sectional study was conducted from July to August 2016 in Nanjing, China, using a self-report questionnaire. Sociodemographic characteristics, infection status, psychosocial variables and suicide ideation reports of participants were collected. Logistic regressions were used to identify potential factors associated with suicidal ideation and to verify the syndemic effect of psychosocial factors. Additionally, odds ratios (ORs) with 95% confidence intervals (95% CI) were computed.ResultsIn total, four hundred sixty-five PLWHA participated, 31.6% (n = 147) of whom had suicidal ideation. The results from univariate analysis showed that older age, low education level, being married, having children, and psychosocial variables (high perceived stigma, depression, low self-esteem, social support and resilience) were significantly associated with increased suicidal ideation. Multiple logistic regression models revealed that depression (OR = 2.70, 95%CI = 1.62–4.51), perceived stigma (OR = 1.97, 95%CI = 1.17–3.32), and low social support (OR = 1.85, 95%CI = 1.08–3.20) and self-esteem (OR = 4.11, 95%CI = 2.06–8.16) were statistically significant. PLWHA with at least two psychosocial health problems were nearly 5 times more likely (OR = 4.72, 95% CI 3.11–7.17) to have had suicidal ideation.ConclusionsSuicidal ideation is frequent among PLWHA in China and is consistent with prevalence estimates from abroad. Psychosocial health problems were the determining factors associated with suicidal ideation, and a syndemic effect of psychosocial health conditions was confirmed in predicting suicidal ideation. Therefore, early screening of high-risk groups for suicidal ideation and more psychosocial health care among PLWHA are needed.

Highlights

HIV/AIDS is a common health care issue, and there are currently more than 34 million people living with HIV/AIDS (PLWHA) globally [1]
PLWHA with at least two psychosocial health problems were nearly 5 times more likely (OR = 4.72, 95% confidence intervals (95% CI) 3.11–7.17) to have had suicidal ideation
Suicidal ideation is frequent among PLWHA in China and is consistent with prevalence estimates from abroad

Summary

Introduction

HIV/AIDS is a common health care issue, and there are currently more than 34 million people living with HIV/AIDS (PLWHA) globally [1]. With an economic boom over the past several decades in China, the number of PLWHA continues to increase, and HIV/AIDS has gradually become a serious public health problem in recent years [2]. A study of suicidal behavior conducted in 17 Western countries found that in the general population, the lifetime prevalence was 9.2% for suicidal ideation, 3.1% for suicide planning, and 2.7% for suicide attempts, but data varied widely among different countries [10]. In China, a recent community prevalence survey reported a prevalence of 2.3% for suicidal ideation and a prevalence of 1.0% for attempted suicide in general Chinese populations [11]. People living with HIV/AIDS (PLWHA) have higher rates of suicidal behavior than the general population.

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