Globally, suicide and HIV/AIDS remain two of the
greatest healthcare issues, particularly in low- and middle-income countries.
Several studies have observed a relationship between suicidal behaviour and
HIV/AIDS. Materials and Methods. The main objective of this research was to
determine the prevalence of elevated risk of suicidal ideation in HIV-positive
persons immediately following voluntary HIV counselling and testing (VCT). The
study sample consisted of adult volunteers attending the VCT clinic at a
university-affiliated, general state hospital. Participants completed a
sociodemographic questionnaire, Beck's Hopeless Scale, and Beck's Depression
Inventory.
A significantly elevated risk of suicidal ideation was
found in 83.1% of the patients who tested seropositive. Despite a wide age
range in the cohort studied, the majority of patients with suicidal ideation
were males in the younger age group (age < 30 years), consistent with the
age-related spread of the disease and an increase in suicidal behaviour in
younger people. Relevant associated variables are discussed.
The
results serve as important markers that could alert healthcare professionals to
underlying suicide risks in HIV-positive patients. It is recommended that
screening for elevated risk of suicidal ideation and prevention of suicidal
behaviour should form a routine aspect of comprehensive patient care at VCT
clinics...
The relationship between HIV/AIDS and elevated risk of
suicidal ideation has, in the past, been underresearched in developing
countries. Despite the diverse findings about correlations between suicidal
behaviour and HIV/AIDS, there is compelling evidence to justify screening for
risk of elevated suicidal ideation and subsequent suicide risk and intervening
as early as possible [36, 45, 46], especially following notification of a
positive HIV test result immediately after HIV counselling and testing. Suicide
risk in other potentially life-threatening medical conditions can be
complicated and has been explored extensively [4], for example, in cancer [47]. In the case of HIV/AIDS, many studies in
different countries [5, 48] have shown that suicidality appears to be
prevalent in some individuals but that it tends to vary according to the stage
of the disease. Nevertheless, it has been shown that screening for suicide,
even among high-risk populations, ultimately does translate into preventing
suicides and that effective suicide prevention includes early recognition and
assessment of risk, immediate response, resource referrals, and follow-up
management and treatment of at-risk individuals [2, 5, 35, 36].
In the resource-limited context of developing societies,
suicide risk assessment and interventions at VCT clinics are hampered by a
shortage of adequately trained healthcare professionals, suicide risk screening
in general, and guidelines for suicide preventive interventions. HIV
counsellors are typically responsible for pre- and posttest HIV counselling and
psychosocial education, and they can easily be task-shifted to screen the
subjects for suicide risk and provide suicide intervention strategies. It is
recommended that this should become routine as part of comprehensive care at
VCT clinics. At a reasonable cost and with minimal training, this could see the
effective reduction of suicidal ideation and ultimate suicide...
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- 1Department of Behavioural Medicine, Nelson R Mandela School of Medicine, University of KwaZulu-Natal, Durban, South Africa.
- 2Department of Family Medicine, Nelson R Mandela School of Medicine, University of KwaZulu-Natal, Durban, South Africa.
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