Psychosomatics 39:405-415, October 1998
© 1998 The Academy of Psychiatric Medicine
Suicidal Ideation, Suicide Attempts, and HIV Infection
Brian Kelly, B.Med., Ph.D., F.R.A.N.Z.C.P.,
B. Raphael, A.M., M.D., F.A.S.S.A., F.R.A.N.Z.C.P., F.R.C.Psych.,
F. Judd, M.D., D.P.M., F.R.A.N.Z.C.P.,
M. Perdices, B.A., M.A., Ph.D.,
G. Kernutt, M.B.B.S., D.P.M., F.R.A.N.Z.C.P.,
P. Burnett, Dip. App. Psych., Ph.D.,
M. Dunne, B.A., Ph.D., and
G. Burrows, M.D., Ch.B., D.P.M., F.R.A.N.Z.C.P., F.R.C.Psych., M.R.A.C.M.A.
Received August 12, 1997; revised February 3, 1998; accepted February 11, 1998. From the Department of Psychiatry, University of Queensland, Brisbane, Queensland, Australia. Address reprint requests to Dr. Kelly, Department of Psychiatry, University of Queensland, Princess Alexandra Hospital, Ipswich Rd., Woolloongabba, QLD, 4102, Australia.
A cross-sectional study was performed to investigate the prevalence and predictors of suicidal ideation and past suicide attempt in an Australian sample of human imumunodeficiency virus (HIV)-positive and HIV-negative homosexual and bisexual men. Sixty-five HIV-negative and 164 HIV-positive men participated. A suicidal ideation score was derived from using five items selected from the Beck Depression Inventory and the General Health Questionnaire (28-item version). Lifetime and current prevalence rates of psychiatric disorder were evaluated with the Diagnostic Interview Schedule Version-III-R. The HIV-positive (Centers for Disease Control and Prevention [CDC] Stage IV) men (n=85) had significantly higher total suicidal ideation scores than the asymptomatic HIV-positive men (CDC Stage II/III) (n=79) and the HIV-negative men. High rates of past suicide attempt were detected in the HIV-negative (29%) and HIV-positive men (21%). Factors associated with suicidal ideation included being HIV-positive, the presence of current psychiatric disorder, higher neuroticism scores, external locus of control, and current unemployment. In the HIV-positive group analyzed separately, higher suicidal ideation was discriminated by the adjustment to HIV diagnosis (greater hopelessness and lower fighting spirit), disease factors (greater number of current acquired immunodeficiency syndrome [AIDS]-related conditions), and background variables (neuroticism). Significant predictors of a past attempted suicide were a positive lifetime history of psychiatric disorder (particularly depression diagnoses), a lifetime history of injection drug use, and a family history of suicide attempts. The findings indicate increased levels of suicidal ideation in symptomatic HIV-positive men and highlight the role that multiple psychosocial factors associated with suicidal ideation and attempted suicide play in this population.
Key Words: HIV • AIDS • Suicide
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