Effect of suicidality on clinical and behavioural outcomes in HIV positive adults in Uganda.

<h4>Introduction</h4>Suicidality is a risk of a person committing suicide often characterized by suicidal ideation, intent or attempts. Despite the high burden of suicidality among individuals living with HIV and HAIDS, there is paucity of data on the impact of suicidality on clinical (s...

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Autores principales:	Godfrey Zari Rukundo, Jonathan Levin, Richard Stephen Mpango, Vikram Patel, Eugene Kinyanda
Formato:	article
Lenguaje:	EN
Publicado:	Public Library of Science (PLoS) 2021
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/2c385dc71e4e4ff4ba4f37ce03660055
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spelling	oai:doaj.org-article:2c385dc71e4e4ff4ba4f37ce036600552021-12-02T20:17:43ZEffect of suicidality on clinical and behavioural outcomes in HIV positive adults in Uganda.1932-620310.1371/journal.pone.0254830https://doaj.org/article/2c385dc71e4e4ff4ba4f37ce036600552021-01-01T00:00:00Zhttps://doi.org/10.1371/journal.pone.0254830https://doaj.org/toc/1932-6203<h4>Introduction</h4>Suicidality is a risk of a person committing suicide often characterized by suicidal ideation, intent or attempts. Despite the high burden of suicidality among individuals living with HIV and HAIDS, there is paucity of data on the impact of suicidality on clinical (such as CD4 counts and HIV disease progression) and behavioural outcomes (such as adherence to HIV Medications). Cross-sectional investigations of these associations are often complicated by bidirectional causal relationships and hence the need for longitudinal study designs. We conducted a cohort study to determine the impact of suicidality on clinical and behavioural outcomes among adults living with HIV/AIDS in Uganda.<h4>Materials and methods</h4>We conducted the study among 1099 ART naïve adults living with HIV/AIDS in Uganda. Data were collected at three time points: baseline, 6 and 12 months. Multiple regression and discrete time survival models were used to determine the relationship between suicidality and indices of HIV outcomes.<h4>Results</h4>Majority of the participants were female and the participant mean age was 35 years. Most of them (73%) had primary or no formal education. The proportion of participants with suicidality decreased from 2.9% at baseline to roughly 1% both at month 6 and month 12. Of the investigated clinical and behavioural outcomes, baseline suicidality only had a negative impact on missing a dose of ART where the odds of missing a dose of ART were 8.25 (95% CI 2.45-27.71, p>0.01) times higher for participants with suicidality compared to those without suicidality. The following outcomes were not significantly impacted by baseline suicidality: HIV clinical stage, CD4 count and risky sexual behaviour.<h4>Conclusions</h4>The fact that baseline suicidality significantly negatively impacted ART adherence calls for the incorporation of psychosocial interventions to target indices of psychological distress such as suicidality to improve HIV related outcomes.Godfrey Zari RukundoJonathan LevinRichard Stephen MpangoVikram PatelEugene KinyandaPublic Library of Science (PLoS)articleMedicineRScienceQENPLoS ONE, Vol 16, Iss 8, p e0254830 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Godfrey Zari Rukundo Jonathan Levin Richard Stephen Mpango Vikram Patel Eugene Kinyanda Effect of suicidality on clinical and behavioural outcomes in HIV positive adults in Uganda.
description	<h4>Introduction</h4>Suicidality is a risk of a person committing suicide often characterized by suicidal ideation, intent or attempts. Despite the high burden of suicidality among individuals living with HIV and HAIDS, there is paucity of data on the impact of suicidality on clinical (such as CD4 counts and HIV disease progression) and behavioural outcomes (such as adherence to HIV Medications). Cross-sectional investigations of these associations are often complicated by bidirectional causal relationships and hence the need for longitudinal study designs. We conducted a cohort study to determine the impact of suicidality on clinical and behavioural outcomes among adults living with HIV/AIDS in Uganda.<h4>Materials and methods</h4>We conducted the study among 1099 ART naïve adults living with HIV/AIDS in Uganda. Data were collected at three time points: baseline, 6 and 12 months. Multiple regression and discrete time survival models were used to determine the relationship between suicidality and indices of HIV outcomes.<h4>Results</h4>Majority of the participants were female and the participant mean age was 35 years. Most of them (73%) had primary or no formal education. The proportion of participants with suicidality decreased from 2.9% at baseline to roughly 1% both at month 6 and month 12. Of the investigated clinical and behavioural outcomes, baseline suicidality only had a negative impact on missing a dose of ART where the odds of missing a dose of ART were 8.25 (95% CI 2.45-27.71, p>0.01) times higher for participants with suicidality compared to those without suicidality. The following outcomes were not significantly impacted by baseline suicidality: HIV clinical stage, CD4 count and risky sexual behaviour.<h4>Conclusions</h4>The fact that baseline suicidality significantly negatively impacted ART adherence calls for the incorporation of psychosocial interventions to target indices of psychological distress such as suicidality to improve HIV related outcomes.
format	article
author	Godfrey Zari Rukundo Jonathan Levin Richard Stephen Mpango Vikram Patel Eugene Kinyanda
author_facet	Godfrey Zari Rukundo Jonathan Levin Richard Stephen Mpango Vikram Patel Eugene Kinyanda
author_sort	Godfrey Zari Rukundo
title	Effect of suicidality on clinical and behavioural outcomes in HIV positive adults in Uganda.
title_short	Effect of suicidality on clinical and behavioural outcomes in HIV positive adults in Uganda.
title_full	Effect of suicidality on clinical and behavioural outcomes in HIV positive adults in Uganda.
title_fullStr	Effect of suicidality on clinical and behavioural outcomes in HIV positive adults in Uganda.
title_full_unstemmed	Effect of suicidality on clinical and behavioural outcomes in HIV positive adults in Uganda.
title_sort	effect of suicidality on clinical and behavioural outcomes in hiv positive adults in uganda.
publisher	Public Library of Science (PLoS)
publishDate	2021
url	https://doaj.org/article/2c385dc71e4e4ff4ba4f37ce03660055
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Effect of suicidality on clinical and behavioural outcomes in HIV positive adults in Uganda.

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