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Factors associated with the occurrence of suicide among French people living with HIV in the HAART era: a nested case-control study in the Dat'AIDS cohort
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from Jules: mark my words we will see increased suicide ideation & suicide among aging older HIV+ and it will be due to the harsh suffering related to premature aging, frailty & disability caused by multiple comorbidities & polypharmacy including cognitive & neurologic dysfunction, bone disease, CVD etc. Yet the problem of HIV and Aging continues to get marginalized & to get the attention & recognition it deserves. All stakeholders refuse to give Aging & HIV the proportionate attention it deserves. We need a National Discussion on Aging to fund better research & to fund & provide special support services for aging older HIV+. We need research focused on real life needs of patients, to better understand the science, and to find real medical interventions. You find the OAR in slide presentations does say Aging with HIV is a problem but nothing more is being done, they have said in 3-5 years they expect to move along research as they try to mobilize a collaboration between NIH institutes, that is too late, we need action NOW. HRSA & RWCA officials should be carving out special support services for aging but they are not. Instead in a meeting CHAC had in November 2016 the comments & discussions showed no sign of timely commitment & action to address the problem. HHS has done nothing, DAIDS will not support expanded aging research addressing real needs. On a national scale both HIV researchers & advocates have dropped the ball. Researchers are out of touch with real needs in this field & are not vocally expressing support to address the real needs - better patient focus research, improved science, special support services for patients - all too often they just want to fund low hanging fruit studies that bring in funding; and advocates almost completely focus on cure & PrEP with a few exceptions.
Reported by Jules Levin
9th IAS Conference on HIV Science (IAS 2017), July 23-26, 2017, Paris
Maxime HENTZIEN1-2, Arthur KALADJIAN3, Pascal PUGLIESE4, eric BILLAUD5, Lise CUZIN6, Claudine DUVIVIER7, Marc-Antoine VALANTIN8, Moustapha DRAMe2,9, FirouzeBANI-SADR1, et le groupe d'etude Dat'AIDS
1Infectious diseasesdepartment, CHU Robert Debre, Reims, France. 2EA 3797, MedicineFaculty, Universite de Reims Champagne-Ardenne, Reims, France. 3Psychiatry unit, CHU Reims. 4Infectious diseasesdepartment, CHU L'Archet, Nice, France. 5Infectious diseasesdepartment, CHU Hotel Dieu, Nantes, France. 9COREVIH Toulouse, France. 7 Infectious and Tropical diseases department, CHU Necker, Paris, France. 8 Infectious and Tropical diseases department, Groupe Hospitalier de la Pitie-Salpetriere, Paris, France. 9Department of Research and Public Health, CHU Robert Debre, Reims, France.
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In UK - Of the 5302 cohort deaths, 4808 (91%) were classifiable by cause with no difference in cause ascertainment over time. Most deaths (2791 [58%]) were attributable to AIDS-defining illnesses (table 2). Among 2017 non-AIDS deaths (tables 2 and 3), most were due to cancer (388 [19%]) followed by: CVD/stroke (378 [19%]), infections (358 [18%]), liver disease (234 [12%]), substance misuse (121 [6%]), suicide (96 [5%]), accident (94 [5%]), and other causes (348 [17%]). The most common other causes were: lung embolus (69 [20%]), renal failure (52 [15%]), other respiratory diseases (37 [11%]), and chronic obstructive pulmonary disease (36 [10%]). Another 32 (9%) were iatrogenic (eg, due to drug toxicity or surgery complications).....The higher mortality due to liver disease in HIV-positive people compared with the general population, irrespective of the time from HIV diagnosis, is most likely multifactorial, including the use of hepatotoxic antiretroviral drugs compounded by co-infections and lifestyle factors, such as obesity and alcohol misuse.24 High levels of substance misuse and depression among MSM diagnosed with HIV have been reported,32 and might account for the high cohort mortality due to suicide and overdose seen among men.
http://www.thelancet.com/journals/lanpub/article/PIIS2468-2667(16)30020-2/fulltext
http://www.bhiva.org/documents/Conferences/2017Liverpool/Presentations/170406/SaraCroxford.pdf
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