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Open Access Research article

The prevalence and characteristics of suicidality in HIV/AIDS as seen in an African population in Entebbe district, Uganda

Eugene Kinyanda1*, Susan Hoskins2, Juliet Nakku3, Saira Nawaz4 and Vikram Patel5

Author Affiliations

1 MRC/UVRI Uganda Research Unit on AIDS & Senior EDCTP Fellowship, P.O. Box 49, Entebbe, Uganda

2 Medical Research Council, Clinical Trials Unit, London, UK

3 Butabika National Psychiatric Referral Hospital, Kampala, Uganda

4 Dartmouth Institute, Dartmouth College, Hanover, USA

5 London School of Hygiene & Tropical Medicine, UK & Wellcome Trust Senior Research Fellow in Clinical Science, London, UK

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BMC Psychiatry 2012, 12:63  doi:10.1186/1471-244X-12-63

Published: 18 June 2012

Abstract

Background

Suicidality in HIV/AIDS is not only a predictor of future attempted suicide and completed suicide, it is also associated with poor quality of life and poor adherence with antiretroviral therapy. This paper examines the prevalence and correlates of suicidality in HIV/AIDS in the African nation of Uganda.

Methods

A cross-sectional study was undertaken among 618 respondents attending two HIV clinics in semi-urban Uganda. A structured questionnaire was used to collect data on demographic, social, psychological and clinical factors. Correlates of suicidality were assessed using mulitvariable logistic regression.

Results

Prevalence of ‘moderate to high risk for suicidality’ (MHS) was 7.8 % and that of life-time attempted suicide was 3.9 %. Factors associated with MHS at univariate analysis were: female gender, food insecurity, increasing negative life events, high stress score, negative coping style, past psychiatric history, psychosocial impairment, diagnoses of post-traumatic stress disorder, generalised anxiety disorder and major depressive disorder. Factors independently associated with MHS in multivariate models were female gender, increasing negative life events, a previous psychiatric history, and major depressive disorder.

Conclusions

These results are in agreement with the stress-vulnerability model where social and psychological stressors acting on an underlying diathesis (including previous and current psychiatric morbidities) leads to suicidality. These results identify potential targets to mitigate risk through treatment of psychiatric disorders and promoting greater adaptation to living with HIV/AIDS.

Keywords:
HIV/AIDS; Suicidality; African population; Attempted suicide; Prevalence