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Arrests, City Stress, Life Events Tied
to Suicide Attempts in Young With HIV
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AIDS 2022, July 29-August 2, Montreal
Mark Mascolini
Recent arrests, city stress, and stressful life events-all linked to systemic racism-raised chances of attempted suicide in a study of 339 young people with or exposed to HIV [1]. HIV-positive young people had about 75% higher odds of a first report of attempted suicide than did HIV-negative youth.
Researchers at the New York State Psychiatric Institute and Columbia University told attendees that suicide rates have climbed 60% globally in the last 45 years, with adolescents and young adults accounting for the biggest part of the increase. For young people in the United States, suicide holds second place among all causes of death.
Their prospective study scrutinized structural, sociodemographic, and psychosocial associations with attempted suicide in 206 young people who acquired HIV perinatally (PLHIV) and 133 young people who were exposed to HIV perinatally but uninfected (HEU). Participants enrolled in 2003-2008 at an average age of 12 years. Current age averaged 28. The investigators determined whether a participant had ever attempted suicide by asking, “Have you ever in your whole life tried to kill yourself or make a suicide attempt?”
The study examined an array of sociodemographic, structural, and psychosocial factors, including HIV stigma for young people with HIV. To identify associations between these factors and a first suicide attempt, the investigators used general estimating equations adjusted for age at each survey (1) for the overall sample, (2) for PLHIV, and (3) for perinatally exposed but uninfected (HEU) participants.
PLHIV did not differ substantially from HEU participants in proportion of males (49% overall), proportion of blacks (60% PLHIV, 53% HEU, P = 0.10), proportion of Latinx people (48% and 53%, P = 0.41), or average age at study entry (12.7 and 12.4, P = 0.19).
For the whole study group, 9 factors were associated with a first suicide attempt in the age-adjusted analysis at the following odds ratios (OR) and 95% confidence intervals (CI):
Whole study group
- HIV-positive (vs negative): OR 1.74, 95% CI 1.04 to 2.92
- Identifies as straight/heterosexual: OR 0.30, 95% CI 0.17 to 0.51 (lowers odds)
- Arrested/jailed in past year: OR 2.56, 95% CI 1.16 to 5.67
- Negative life events: OR 1.23, 95% CI 1.09 to 1.39
- City stress: OR 2.07, 95% CI 1.40 to 3.06
- Personal self-concept: OR 0.51, 95% CI 0.32 to 0.83 (lowersodds)
- Family self-concept: OR 0.40, 95% CI 0.26 to 0.60 (lowersodds)
- Any DISC* psychiatric disorder (yes vs no): OR 3.32, 95% CI 2.06 to 5.35
- DISC* substance disorder (yes vs no): OR 2.60, 95% CI 1.49 to 4.53
Associations with first suicide attempt in young PLHIV were similar but differed slightly from the overall group:
PLHIV young people
- Identifies as straight/heterosexual: OR 0.27, 95% CI 0.14 to 0.52 (lowers odds)
- Pregnancy (self or partner): OR 2.28, 95% CI 1.08 to 4.81
- Arrested/jailed in past year: OR 3.05, 95% CI 1.26 to 7.40v
- Negative life events: OR 1.27, 95% CI 1.11 to 1.46
- City stress: OR 2.28, 95% CI 1.46 to 3.57
- HIV stigma: OR 2.46, 95% CI 1.27 to 4.75
- Personal self-concept: OR 0.45, 95% CI 0.26 to 0.80 (lowersodds)
- Family self-concept: OR 0.36, 95% CI 0.22 to 0.57 (lowersodds)
- Any DISC* psychiatric disorder (yes vs no): OR 3.15, 95% CI 1.77 to 5.60
For HIV-exposed but uninfected youth, only two variables were associated with first suicide attempt:
HEU young people
- Any DISC* psychiatric disorder (yes vs no): OR 4.60, 95% CI 1.84 to 11.51
- DISC* substance disorder (yes vs no): OR 5.83, 95% CI 2.23to 15.29
The New York State/Columbia team noted that three variables associated with a suicide attempt in adolescents and young adults-recent arrests, city stress, and stressful life events-are linked to systemic racism in other research. The investigators saw a need for more research on (1) possible links between HIV stigma, pregnancy, and suicide in young people with HIV infection, and (2) family and personal self-concept as protective factors. For youth with HIV, they suggested that existing interactions with medical clinics may offer opportunities to intervene and address suicide in this vulnerable group.
*Diagnostic Interview Schedule for Children.
Reference
1. Kreniske P, Morrison C, Spencer BH, et al. HIV and suicide risk across adolescence and young adulthood: an examination of sociodemographic, contextual, and psychosocial risk factors for attempted suicide in a longitudinal cohort of youth affected by HIV. AIDS 2022, July 29-August 2, Montreal. Abstract OAD0705.
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