M Hentzien1, A Cabie2, P Pugliese3, É Billaud4, I Poizot-Martin5,6, C Duvivier7, M-A Valantin8, A Kaladjian9, M Dramé10,11, F Bani-Sadr1,12. 1. Department of Internal Medicine, Clinical Immunology and Infectious Diseases, Reims University Hospital, University of Reims Champagne-Ardenne, Reims, France. 2. Infectious and Tropical Diseases Unit, INSERM CIC1424, University Hospital of Martinique, Fort de France, France. 3. Department of Infectious Diseases, Nice University Hospital, Nice, France. 4. Department of Infectious Diseases, Nantes University Hospital, Nantes, France. 5. Immuno-Hematology Clinic, Marseille University Hospital, Marseille, France. 6. INSERM U912 (SESSTIM), Aix Marseille University, Marseille, France. 7. Assistance Publique des Hôpitaux de Paris, Necker Pasteur Center for Infectious Diseases and Tropical Medicine, IHU Imagine, Paris, France. 8. Department of Infectious Diseases, Assistance Publique des Hôpitaux de Paris, Pitié-Salpêtrière Hospital, Paris, France. 9. Department of Adult Psychiatry, Reims University Hospital, Reims, France. 10. Department of Research and Public Health, Reims University Hospital, Reims, France. 11. Faculty of Medicine, EA 3797, University of Reims Champagne-Ardenne, Reims, France. 12. EA-4684/SFR CAP-SANTE, University of Reims Champagne-Ardenne, Reims, France.
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.
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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