Alexandria C Smith, Joseph L Goulet, David Vlahov, Amy C Justice, Julie A Womack
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引用次数: 0
Abstract
Objective: People with HIV (PWH) are at an increased risk of suicide and death from unintentional causes compared with people living without HIV. Broadening the categorization of death from suicide to self-injurious unnatural death (SIUD) may better identify a more complete set of modifiable risk factors that could be targeted for prevention efforts among PWH.
Design: We conducted a nested case-control study using data from the Veterans Aging Cohort Study (VACS), a longitudinal, observational cohort of Veterans from 2006-2015. A total of 5036 Veterans with HIV, of whom 461 died by SIUD, were included in the sample.
Methods: SIUD was defined using the International Classification of Disease 10 th revision cause of death codes. Cases ( n = 461) included individuals who died by SIUD (intentional, unintentional, and undetermined causes of death). Controls ( n = 4575) were selected using incidence density sampling, matching on date of birth ± 1 year, race, sex, and HIV status. SIUD and suicide was estimated using conditional logistic regression.
Results: A previous suicide attempt, a diagnosis of an affective disorder, recent use of benzodiazepines, psychiatric hospitalization, and living in the western US significantly increased the risk of suicide and SIUD. Risk factors that appear more important for SIUD than for suicide included a drug use disorder, alcohol use disorder, Hepatitis C, VACS Index 2.0, current smoking, and high pain levels (7-10).
Conclusion: Limiting studies to known suicides obscures the larger public health burden of excess deaths from self-injurious behavior. Our findings demonstrate the benefit of expanding the focus to SIUD for the identification of modifiable risk factors that could be targeted for treatment.
期刊介绍:
Publishing the very latest ground breaking research on HIV and AIDS. Read by all the top clinicians and researchers, AIDS has the highest impact of all AIDS-related journals. With 18 issues per year, AIDS guarantees the authoritative presentation of significant advances. The Editors, themselves noted international experts who know the demands of your work, are committed to making AIDS the most distinguished and innovative journal in the field. Submitted articles undergo a preliminary review by the editor. Some articles may be returned to authors without further consideration. Those being considered for publication will undergo further assessment and peer-review by the editors and those invited to do so from a reviewer pool.