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Journal of the International AIDS Society
09, 2022;25 Suppl 4 e25984.

HIV and suicide risk across adolescence and young adulthood: an examination of socio-demographic, contextual and psychosocial risk factors for attempted suicide in a longitudinal cohort of ageing adolescents affected by HIV living in the New York City Area.

Philip Kreniske, Corey Morrison, Bailey Holmes Spencer, Alina Levine, Lucy Liotta, Prudence W Fisher, Nadia Nguyen, Reuben N Robbins, Curtis Dolezal, Luke Kluisza, Andrew Wiznia, Elaine J Abrams, Claude A Mellins
Author Information
  1. Philip Kreniske: HIV Center for Clinical and Behavioral Studies, New York State Psychiatric Institute and Columbia University, New York City, New York, USA. ORCID
  2. Corey Morrison: HIV Center for Clinical and Behavioral Studies, New York State Psychiatric Institute and Columbia University, New York City, New York, USA.
  3. Bailey Holmes Spencer: Department of Population and Family Health, Mailman School of Public Health, Columbia University, New York City, New York, USA.
  4. Alina Levine: Mental Health Data Science, Research Foundation for Mental Hygiene, New York City, New York, USA.
  5. Lucy Liotta: HIV Center for Clinical and Behavioral Studies, New York State Psychiatric Institute and Columbia University, New York City, New York, USA. ORCID
  6. Prudence W Fisher: Child and Adolescent Psychiatry, New York State Psychiatric Institute and Columbia University, New York City, New York, USA.
  7. Nadia Nguyen: The Aaron Diamond AIDS Research Center, New York City, New York, USA. ORCID
  8. Reuben N Robbins: HIV Center for Clinical and Behavioral Studies, New York State Psychiatric Institute and Columbia University, New York City, New York, USA. ORCID
  9. Curtis Dolezal: HIV Center for Clinical and Behavioral Studies, New York State Psychiatric Institute and Columbia University, New York City, New York, USA.
  10. Luke Kluisza: HIV Center for Clinical and Behavioral Studies, New York State Psychiatric Institute and Columbia University, New York City, New York, USA.
  11. Andrew Wiznia: Jacobi Medical Center, Albert Einstein College of Medicine, Bronx, New York, USA.
  12. Elaine J Abrams: ICAP at Columbia University, Mailman School of Public Health and Vagelos College of Physicians & Surgeons, Columbia University, New York City, New York, USA.
  13. Claude A Mellins: HIV Center for Clinical and Behavioral Studies, New York State Psychiatric Institute and Columbia University, New York City, New York, USA.
PMID: 36176026 DOI: 10.1002/jia2.25984

Abstract

INTRODUCTION: As children become adolescents and young adults (AYA), their risk for attempting suicide increases dramatically, with chronic health conditions an important risk factor. This study examined correlates of suicidality across development in AYA living with perinatally acquired HIV (AYALPHIV) and those perinatally HIV-exposed but uninfected (AYAPHEU).
METHODS: Data come from an ongoing longitudinal New York City-based study (N = 339) with AYALPHIV and AYAPHEU interviewed every 12-18 months from 2003 to 2019 (mean enrolment age = 12 years; current mean age = 27 years). The Diagnostic Interview Schedule for Children (adolescent or young adult version) assessed psychiatric disorders and first-reported suicide attempt. Generalized estimating equations were used to examine associations between first-reported suicide attempt and socio-demographic, contextual and psychosocial correlates measured concurrently across six timepoints.
RESULTS: At enrolment, 51% of participants were female, 72% heterosexual, 60% Black and 50% Latinx. Attempted suicide was significantly higher among AYALPHIV (27%, CI 21-33%) compared to AYAPHEU (16%, CI 10-22%), with an OR of 1.74 (CI 1.04-2.92) in a model adjusting for age. For AYALPHIV, anxiety (OR 2.66, CI 1.46-4.85), mood (OR 3.62, CI 1.49-8.81) and behaviour disorders (OR 5.05, CI 2.15-11.87) and past-year arrest (OR 3.05, CI 1.26-7.4), negative life events (OR 1.27, CI 1.11-1.46), city stress (OR 2.28, CI 1.46-3.57), pregnancy (OR 2.28, CI 1.08-4.81) and HIV stigma (OR 2.46, CI 1.27-4.75) were associated with increased odds of attempted suicide, while identifying as heterosexual (OR 0.27, CI 0.14-0.52), higher personal (OR 0.45, CI 0.26-0.80) and family self-concept (OR 0.36, CI 0.22-0.57) were protective. Interactions by HIV status and age were found: substance use was more strongly associated with attempted suicide among AYAPHEU than AYALPHIV, while negative life events and higher religiosity were more strongly associated with increased odds of attempted suicide among AYA ≥ 19 versus ≤ 18 years.
CONCLUSIONS: AYALPHIV compared to AYAPHEU faced unique risks for attempted suicide as they age into adulthood, with the highest risk among AYALPHIV experiencing HIV stigma or pregnancy and the highest risk among AYAPHEU with substance use. Assessing for suicide risk and correlates with attention to ageing can inform preventive interventions tailored to meet AYALPHIV and AYAPHEU needs.

Keywords

HIV HIV stigma adolescents cohort studies suicide young adults

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Grants

  1. K01 MH122319/NIMH NIH HHS
  2. P30 MH043520/NIMH NIH HHS
  3. R01 MH069133/NIMH NIH HHS

MeSH Term

Adolescent
Adult
Child
Demography
Female
HIV Infections
Humans
Male
New York City
Risk Factors
Substance-Related Disorders
Suicide, Attempted
Young Adult
Journal Article Research Support, Non-U.S. Gov't Research Support, N.I.H., Extramural
Article has an altmetric score of 4

Word Cloud

Created with Highcharts 10.0.0CIsuicideOR1HIVAYALPHIVriskAYAPHEU0ageamong2attemptedyoungadolescentsAYAcorrelatesacross=years27higherstigmaassociatedadultsstudylivingperinatallylongitudinalNewYorkmeanenrolmentdisordersfirst-reportedattemptsocio-demographiccontextualpsychosocialheterosexualcompared38105negativelifeevents462857pregnancyincreasedoddssubstanceusestronglyhighestageingcohortINTRODUCTION:childrenbecomeattemptingincreasesdramaticallychronichealthconditionsimportantfactorexaminedsuicidalitydevelopmentacquiredHIV-exposeduninfectedMETHODS:DatacomeongoingCity-basedN339interviewedevery12-18months2003201912currentDiagnosticInterviewScheduleChildrenadolescentadultversionassessedpsychiatricGeneralizedestimatingequationsusedexamineassociationsmeasuredconcurrentlysixtimepointsRESULTS:51%participantsfemale72%60%Black50%LatinxAttemptedsignificantly27%21-33%16%10-22%7404-292modeladjustinganxiety6646-485mood6249-8behaviour515-1187past-yeararrest26-7411-1citystress46-308-427-475identifying14-052personal4526-080familyself-concept3622-0protectiveInteractionsstatusfound:religiosity≥19versus≤18CONCLUSIONS:faceduniquerisksadulthoodexperiencingAssessingattentioncaninformpreventiveinterventionstailoredmeetneedsadolescenceadulthood:examinationfactorsaffectedCityAreastudies

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