Mortality from suicide among people living with HIV and the general Swiss population: 1988-2017.

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State: Public
Version: Final published version
License: CC BY 4.0
Serval ID
serval:BIB_3683258251EB
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Mortality from suicide among people living with HIV and the general Swiss population: 1988-2017.
Journal
Journal of the International AIDS Society
Author(s)
Ruffieux Y., Lemsalu L., Aebi-Popp K., Calmy A., Cavassini M., Fux C.A., Günthard H.F., Marzolini C., Scherrer A., Vernazza P., Keiser O., Egger M.
Working group(s)
Swiss HIV Cohort Study and the Swiss National Cohort
Contributor(s)
Anagnostopoulos A., Battegay M., Bernasconi E., Böni J., Braun D.L., Bucher H.C., Ciuffi A., Dollenmaier G., Elzi L., Fehr J., Fellay J., Furrer H., Haerry D., Hasse B., Hirsch H.H., Hoffmann M., Hösli I., Huber M., Kahlert C.R., Kaiser L., Klimkait T., Kouyos R.D., Kovari H., Ledergerber B., Martinetti G., Martinez de Tejada B., Metzner K.J., Müller N., Nicca D., Paioni P., Pantaleo G., Perreau M., Rauch A., Rudin C., Schmid P., Speck R., Stöckle M., Tarr P., Trkola A., Wandeler G., Weber R., Yerly S.T.
ISSN
1758-2652 (Electronic)
ISSN-L
1758-2652
Publication state
Published
Issued date
08/2019
Peer-reviewed
Oui
Volume
22
Number
8
Pages
e25339
Language
english
Notes
Publication types: Journal Article ; Research Support, Non-U.S. Gov't
Publication Status: ppublish
Abstract
In many countries, mortality due to suicide is higher among people living with HIV than in the general population. We aimed to analyse trends in suicide mortality before and after the introduction of triple combination antiretroviral therapy (cART), and to identify risk factors associated with death from suicide in Switzerland.
We analysed data from the Swiss HIV Cohort Study from the pre-cART (1988-1995), earlier cART (1996-2008) and later cART (2009-2017) eras. We used multivariable Cox regression to assess risk factors for death due to suicide in the ART era and computed standardized mortality ratios (SMRs) to compare mortality rates due to suicide among persons living with HIV with the general population living in Switzerland, using data from the Swiss National Cohort.
We included 20,136 persons living with HIV, of whom 204 (1.0%) died by suicide. In men, SMRs for suicide declined from 12.9 (95% CI 10.4-16.0) in the pre-cART era to 2.4 (95% CI 1.2-5.1) in the earlier cART and 3.1 (95% CI 2.3-4.3) in the later cART era. In women, the corresponding ratios declined from 14.2 (95% CI 7.9-25.7) to 10.2 (3.8-27.1) and to 3.3 (95% CI 1.5-7.4). Factors associated with death due to suicide included gender (adjusted hazard ratio 0.58 (95% CI 0.38-0.87) comparing women with men), nationality (1.95 (95% CI 1.34-2.83) comparing Swiss with other), Centers for Disease Control and Prevention clinical stage (0.33 (95% CI 0.24-0.46) comparing stage A with C), transmission group (2.64 (95% CI 1.71-4.09) for injection drug use and 2.10 (95% CI 1.36-3.24) for sex between men compared to other), and mental health (2.32 (95% CI 1.71-3.14) for a history of psychiatric treatment vs. no history). There was no association with age.
Suicide rates have decreased substantially among people living with HIV in the last three decades but have remained about three times higher than in the general population since the introduction of cART. Continued emphasis on suicide prevention among men and women living with HIV is important.
Keywords
Adult, Anti-Retroviral Agents/therapeutic use, Antiretroviral Therapy, Highly Active/methods, Cohort Studies, Female, HIV Infections/drug therapy, HIV Infections/mortality, Humans, Male, Middle Aged, Risk Factors, Suicide/statistics & numerical data, Switzerland/epidemiology, HIV, SMR, Switzerland, comparative study, intravenous drug use, suicide
Pubmed
Web of science
Open Access
Yes
Create date
16/09/2019 21:34
Last modification date
15/01/2021 7:08
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