Observational Study

. 2014 Feb 19;9(2):e89089.

doi: 10.1371/journal.pone.0089089. eCollection 2014.

Determinants of suicide and accidental or violent death in the Australian HIV Observational Database

Collaborators, Affiliations

Collaborators

Australian HIV Observational Database:
D Ellis, M Bloch, T Franic, S Agrawal, L McCann, N Cunningham, T Vincent, D Allen, J L Little, D Smith, C Gray, D Baker, R Vale, D J Templeton, C C O'Connor, C Dijanosic, E Jackson, K McCallum, M Grotowski, S Taylor, D Cooper, A Carr, F Lee, K Hesse, K Sinn, R Norris, R Finlayson, I Prone, E Jackson, J Shakeshaft, K Brown, C McGrath, V McGrath, S Halligan, L Wray, P Read, H Lu, D Couldwell, D Smith, V Furner, J Watson, C Lawrence, B Mulhall, M Law, K Petoumenos, S Wright, H McManus, C Bendall, M Boyd, A Kulatunga, P Knibbs, J Chuah, M Ngieng, B Dickson, D Russell, S Downing, D Sowden, J Broom, K Taing, C Johnston, K McGill, D Orth, D Youds, M Kelly, A Gibson, H Magon, W Donohue, R Moore, S Edwards, R Liddle, P Locke, N J Roth, J Nicolson, H Lau, T Read, J Silvers, W Zeng, J Hoy, K Watson, M Bryant, S Price, I Woolley, M Giles, T Korman, J Williams, D Nolan, J Skett, J Robinson, D Sowden, D J Templeton, J Hoy, L Wray, J Chuah, K Morwood, T Read, N Roth, I Woolley, M Kelly, J Broom, P C K Li, M P Lee, S Vanar, S Faridah, A Kamarulzaman, J Y Choi, B Vannary, R Ditangco, K Tsukada, S H Han, S Pujari, A Makane, O T Ng, A J Sasisopin, F Drummond, M Boyd

Affiliations

¹ The Kirby Institute, University of New South Wales, Sydney, Australia.
² Holdsworth House GP, Sydney, Australia.
³ Brisbane Sexual Health and HIV Service, Brisbane, Queensland, Australia.
⁴ National Association of People with HIV Australia, Sydney, Australia.
⁵ The Kirby Institute, University of New South Wales, Sydney, Australia ; RPA Sexual Health, Royal Prince Alfred Hospital, Sydney, Australia ; Central Clinical School, Sydney University, Sydney, Australia.
⁶ Department of Medicine, Monash University, Melbourne, Victoria, Australia.

PMID: 24586519
PMCID: PMC3929688
DOI: 10.1371/journal.pone.0089089

Observational Study

Determinants of suicide and accidental or violent death in the Australian HIV Observational Database

Hamish McManus et al. PLoS One. 2014.

. 2014 Feb 19;9(2):e89089.

doi: 10.1371/journal.pone.0089089. eCollection 2014.

Collaborators

Australian HIV Observational Database:
D Ellis, M Bloch, T Franic, S Agrawal, L McCann, N Cunningham, T Vincent, D Allen, J L Little, D Smith, C Gray, D Baker, R Vale, D J Templeton, C C O'Connor, C Dijanosic, E Jackson, K McCallum, M Grotowski, S Taylor, D Cooper, A Carr, F Lee, K Hesse, K Sinn, R Norris, R Finlayson, I Prone, E Jackson, J Shakeshaft, K Brown, C McGrath, V McGrath, S Halligan, L Wray, P Read, H Lu, D Couldwell, D Smith, V Furner, J Watson, C Lawrence, B Mulhall, M Law, K Petoumenos, S Wright, H McManus, C Bendall, M Boyd, A Kulatunga, P Knibbs, J Chuah, M Ngieng, B Dickson, D Russell, S Downing, D Sowden, J Broom, K Taing, C Johnston, K McGill, D Orth, D Youds, M Kelly, A Gibson, H Magon, W Donohue, R Moore, S Edwards, R Liddle, P Locke, N J Roth, J Nicolson, H Lau, T Read, J Silvers, W Zeng, J Hoy, K Watson, M Bryant, S Price, I Woolley, M Giles, T Korman, J Williams, D Nolan, J Skett, J Robinson, D Sowden, D J Templeton, J Hoy, L Wray, J Chuah, K Morwood, T Read, N Roth, I Woolley, M Kelly, J Broom, P C K Li, M P Lee, S Vanar, S Faridah, A Kamarulzaman, J Y Choi, B Vannary, R Ditangco, K Tsukada, S H Han, S Pujari, A Makane, O T Ng, A J Sasisopin, F Drummond, M Boyd

Affiliations

¹ The Kirby Institute, University of New South Wales, Sydney, Australia.
² Holdsworth House GP, Sydney, Australia.
³ Brisbane Sexual Health and HIV Service, Brisbane, Queensland, Australia.
⁴ National Association of People with HIV Australia, Sydney, Australia.
⁵ The Kirby Institute, University of New South Wales, Sydney, Australia ; RPA Sexual Health, Royal Prince Alfred Hospital, Sydney, Australia ; Central Clinical School, Sydney University, Sydney, Australia.
⁶ Department of Medicine, Monash University, Melbourne, Victoria, Australia.

PMID: 24586519
PMCID: PMC3929688
DOI: 10.1371/journal.pone.0089089

Abstract

Background: Rates of suicide and accidental or violent death remain high in HIV-positive populations despite significantly improved prognosis since the introduction of cART.

Methods: We conducted a nested case-control study of suicide and accidental or violent death in the Australian HIV Observational Database (AHOD) between January 1999 and March 2012. For each case, 2 controls were matched by clinic, age, sex, mode of exposure and HIV-positive date to adjust for potential confounding by these covariates. Risk of suicide and accidental or violent death was estimated using conditional logistic regression.

Results: We included 27 cases (17 suicide and 10 violent/accidental death) and 54 controls. All cases were men who have sex with men (MSM) or MSM/ injecting drug use (IDU) mode of exposure. Increased risk was associated with unemployment (Odds Ratio (OR) 5.86, 95% CI: 1.69-20.37), living alone (OR 3.26, 95% CI: 1.06-10.07), suicidal ideation (OR 6.55, 95% CI: 1.70-25.21), and >2 psychiatric/cognitive risk factors (OR 4.99, 95% CI: 1.17-30.65). CD4 cell count of >500 cells/µL (OR 0.25, 95% CI: 0.07-0.87) and HIV-positive date ≥1990 (1990-1999 (OR 0.31, 95% CI: 0.11-0.89), post-2000 (OR 0.08, 95% CI: 0.01-0.84)) were associated with decreased risk. CD4 cell count ≥500 cells/µL remained a significant predictor of reduced risk (OR 0.15, 95% CI: 0.03-0.70) in a multivariate model adjusted for employment status, accommodation status and HIV-positive date.

Conclusions: After adjustment for psychosocial factors, the immunological status of HIV-positive patients contributed to the risk of suicide and accidental or violent death. The number of psychiatric/cognitive diagnoses contributed to the level of risk but many psychosocial factors were not individually significant. These findings indicate a complex interplay of factors associated with risk of suicide and accidental or violent death.

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Conflict of interest statement

Competing Interests: The authors have the following interests: the Australian HIV Observational Database is funded in part by unconditional grants from Merck Sharp & Dohme; Gilead; Bristol-Myers Squibb; Boehringer Ingelheim; Roche; Pfizer; GlaxoSmithKline; Janssen-Cilag. MGL has received research grants, consultancy and/or travel grants from Boehringer Ingelheim; Bristol-Myers Squibb; Gilead; GlaxoSmithKline; Janssen-Cilag; Johnson & Johnson; Merck Sharp & Dohme; Pfizer; Roche; and CSL Ltd. JH’s institution has received funding for investigator-initiated research, advisory board honorarium and conference sponsorship from Janssen-Cilag, Gilead Sciences, Merck Sharp & Dohme, and ViiV Healthcare. This does not alter their adherence to all the PLOS ONE policies on sharing data and materials.

References

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Determinants of suicide and accidental or violent death in the Australian HIV Observational Database

Collaborators

Affiliations

Determinants of suicide and accidental or violent death in the Australian HIV Observational Database

Authors

Collaborators

Affiliations

Abstract

Conflict of interest statement

References

Publication types

MeSH terms

Grants and funding

LinkOut - more resources

Full Text Sources

Other Literature Sources

Medical

Research Materials