Journal article
Determinants of suicide and accidental or violent death in the Australian HIV Observational Database
PLoS ONE, Vol.9(2), e89089
2014
Abstract
BACKGROUND:
Rates of suicide and accidental or violent death remain high in HIV-positive populations despite significantly improved prognosis since the introduction of cART.
METHODS:
We conducted a nested case-control study of suicide and accidental or violent death in the Australian HIV Observational Database (AHOD) between January 1999 and March 2012. For each case, 2 controls were matched by clinic, age, sex, mode of exposure and HIV-positive date to adjust for potential confounding by these covariates. Risk of suicide and accidental or violent death was estimated using conditional logistic regression.
RESULTS:
We included 27 cases (17 suicide and 10 violent/accidental death) and 54 controls. All cases were men who have sex with men (MSM) or MSM/ injecting drug use (IDU) mode of exposure. Increased risk was associated with unemployment (Odds Ratio (OR) 5.86, 95% CI: 1.69-20.37), living alone (OR 3.26, 95% CI: 1.06-10.07), suicidal ideation (OR 6.55, 95% CI: 1.70-25.21), and >2 psychiatric/cognitive risk factors (OR 4.99, 95% CI: 1.17-30.65). CD4 cell count of >500 cells/µL (OR 0.25, 95% CI: 0.07-0.87) and HIV-positive date ≥1990 (1990-1999 (OR 0.31, 95% CI: 0.11-0.89), post-2000 (OR 0.08, 95% CI: 0.01-0.84)) were associated with decreased risk. CD4 cell count ≥500 cells/µL remained a significant predictor of reduced risk (OR 0.15, 95% CI: 0.03-0.70) in a multivariate model adjusted for employment status, accommodation status and HIV-positive date.
CONCLUSIONS:
After adjustment for psychosocial factors, the immunological status of HIV-positive patients contributed to the risk of suicide and accidental or violent death. The number of psychiatric/cognitive diagnoses contributed to the level of risk but many psychosocial factors were not individually significant. These findings indicate a complex interplay of factors associated with risk of suicide and accidental or violent death.
Details
- Title
- Determinants of suicide and accidental or violent death in the Australian HIV Observational Database
- Authors/Creators
- G. Pendyala (Author/Creator)H. McManus (Author/Creator) - Kirby InstituteK. Petoumenos (Author/Creator) - Kirby InstituteT. Franic (Author/Creator) - Nashotah House Theological SeminaryM.D. Kelly (Author/Creator)J. Watson (Author/Creator) - National Association of People with HIV AustraliaC.C. O’Connor (Author/Creator)M. Jeanes (Author/Creator) - Monash UniversityJ. Hoy (Author/Creator) - Monash UniversityD.A. Cooper (Author/Creator) - Kirby InstituteM.G. Law (Author/Creator) - Kirby InstituteD. Nolan (Author/Creator)
- Publication Details
- PLoS ONE, Vol.9(2), e89089
- Publisher
- Public Library of Science
- Identifiers
- 991005542413807891
- Murdoch Affiliation
- Institute for Immunology and Infectious Diseases
- Language
- English
- Resource Type
- Journal article
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- Collaboration types
- Domestic collaboration
- Citation topics
- 1 Clinical & Life Sciences
- 1.66 HIV
- 1.66.11 HIV/AIDS Prevention
- Web Of Science research areas
- Psychiatry
- ESI research areas
- Psychiatry/Psychology