Suicidality among nonadherent patients living with HIV in Buenos Aires, Argentina: prevalence and correlates

ABSTRACT

Of those in the general population hospitalized for suicidal ideation and suicide attempts in Argentina, many reattempt suicide and are readmitted. However, few studies in Argentina have examined suicidal ideation and suicide-related behaviors among people living with HIV (PLHIV) and none have examined these factors among nonadherent PLHIV, though the prevalence of suicidal ideation in this group may be higher than in the general population and also than in other groups of PLHIV. This study of PLHIV in Buenos Aires, Argentina, examined the correlates of suicidal ideation in nonadherent PLHIV. Nonadherent patients with HIV (N = 118) were recruited from two clinics providing outpatient healthcare services to PLHIV in Buenos Aires, Argentina. Participants completed assessments on demographic characteristics, depression and suicidality, stigma, and self-efficacy. Participants were HIV-infected men (51%) and women (49%) with a median age of 40 years (IQR = 11). About half had completed high school or more, two-thirds were employed, and had a mean monthly income of 4196.79 (SD = 3179.64) Argentine pesos (USD$221). Thirty-three (28% [95% CI 20.3, 37.3]) participants reported suicidal ideation in the past two weeks, and one-third (35.6% [27.1, 44.9]) reported lifetime suicidal ideation. In bivariate analyses, attending a public clinic, being female, younger, unemployed, and experiencing greater stigma and depression were associated with suicidal ideation. In multivariable logistic regression, stigma interacted with the number of years since HIV diagnosis to predict suicidal ideation. The impact of stigma on suicidal ideation decreased with time since HIV diagnosis, suggesting that suicidal ideation may arise following HIV diagnosis due to perception of HIV-related stigma. Interventions to reduce perceived stigma during the period following HIV diagnosis may reduce suicidal ideation in this population. Organizational initiatives that explore HIV stigma microagressions in the healthcare setting may be needed to optimize health outcomes.

KEYWORDS:

• HIV
• suicidal ideation
• Argentina
• South America

Acknowledgements

We thank all the members of the COPA study team, as well as the medical providers and patients, without whom this study would not have been possible.

Disclosure statement

No potential conflict of interest was reported by the authors.

Disclaimer

The views expressed in this article are those of the author and are not official positions of the University of Miami Miller School of Medicine, Fundación Huésped, Helios Salud, or the National Institutes of Health.

ORCID

Violeta J Rodriguez http://orcid.org/0000-0001-8543-2061

Stephen M Weiss http://orcid.org/0000-0001-6266-6148

Additional information

Funding

This study was funded the National Institute of Mental Health, R34MH097609, with support from the University of Miami Center for AIDS Research through funding from the National Institute of Allergies and Infectious Diseases, P30AI073961.