Suicidal ideation in UKHIV clinic attenders

被引:82
作者
Sherr, Lorraine [1 ]
Lampe, Fiona
Fisher, Martin [1 ,2 ]
Arthur, Gilly [3 ]
Anderson, Jane [4 ]
Zetler, Sarah [4 ]
Johnson, Margaret [7 ]
Edwards, Simon [5 ]
Harding, Richard [6 ]
机构
[1] UCL Royal Free & Univ Coll Med Sch, London NW3 2PF, England
[2] Brighton & Hove Sussex Univ Hosp NHS Trust, Brighton, E Sussex, England
[3] Archway Sexual Hlth Clin, London, England
[4] Homerton Univ Hosp NHS Fdn Trust, London, England
[5] Camden PCT, Mortimer Market Ctr, Dept Genitourinary Med, London, England
[6] Kings Coll London, Sch Med, Dept Palliat Care Policy & Rehabil, London WC2R 2LS, England
[7] UCL Royal Free Ctr HIV Med, London, England
关键词
adherence; HIV; psychological burden; suicidal ideation;
D O I
10.1097/QAD.0b013e32830c4804
中图分类号
R392 [医学免疫学]; Q939.91 [免疫学];
学科分类号
100102 ;
摘要
Background: FIN has been associated with elevated suicidal ideation. Although new treatments have changed prognosis, they also bring new challenges. This study measured Suicidal ideation in HIV clinic attenders in the United Kingdom (London/Southeast) and explored associated factors. Method: All 1006 attenders at five HIV clinics were approached, of which 903 met inclusion criteria and 778 participated (861% response). Participants provided detailed information on suicidal ideation, demographics, treatment, adherence, symptoms (psychological and physical oil Memorial Symptom Assessment Schedule), quality of life (EuroQol) information, HIV disclosure, clinical variables, sexual risk behaviour and treatment optimism. Results: There was a 31%, prevalence Of Suicidal ideation. Factors associated with Suicidal ideation were being a heterosexual mail, black ethnicity, unemployment, lack of disclosure of HIV status, having stopped antiretroviral treatment (compared to treatment or treatment naive), physical symptoms, psychological symptoms and poorer quality of life. There was no association with sexual risk behaviour. Sex/sexuality and ethnicity were independently associated with Suicidal ideation: the odds Of Suicidal ideation increased almost two-fold for heterosexual men compared with gay men or women and for black respondents compared with White or Asian respondents. Lack of disclosure was independently associated with a two-fold increase in odds of suicidal ideation. Elevated physical and psychological symptoms were strong independent predictors of suicidal ideation. Independent predictors of suicidal ideation were very similar among the subgroup of 492 patients oil antiretroviral treatment. Conclusion: Despite advances in treatment, suicidal ideation rates among HIV-positive clinic attenders are high. Emotional Support and attention to mental health provision and social context are strongly endorsed. (C) 2008 Wolters Kluwer Health | Lippincott Williams & Wilkins
引用
收藏
页码:1651 / 1658
页数:8
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