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. 2021 Jan 23;15(1):13.
doi: 10.1186/s13033-021-00437-3.

Suicidal ideation, attempt, and its associated factors among HIV/AIDS patients in Africa: a systematic review and meta-analysis study

Mogesie Necho  1 , Mekonnen Tsehay  2 , Yosef Zenebe  2
Affiliations

Suicidal ideation, attempt, and its associated factors among HIV/AIDS patients in Africa: a systematic review and meta-analysis study

Mogesie Necho et al. Int J Ment Health Syst. .

Abstract

Background: Suicidal ideation and suicidal attempt are warning signs for and determine the prognosis of completed suicide. These suicidal behaviors are much more pronounced in people living with HIV/AIDS. Despite this, there is a scarcity of aggregate evidence in Africa. This study was therefore aimed to fill this gap.

Methods: we extensively searched Psych-info, PubMed, Scopus, and EMBASE to obtain eligible studies. Further screening for a reference list of articles was also done. Meta XL package was used to extract data and the Stata-11 was also employed. Cochran's Q- and the Higgs I2 test were engaged to check heterogeneity. Sensitivity and subgroup analysis were implemented. Egger's test and funnel plots were used in detecting publication bias.

Results: The pooled prevalence of suicidal ideation was 21.7% (95% CI 16.80, 26.63). The pooled prevalence of suicidal ideation in Ethiopia, Nigeria, Uganda, and South Africa was 22.7%, 25.3%, 9.8%, and 18.05% respectively. The pooled prevalence of suicidal ideation was larger; 27.7% in studies that used Composite International Diagnostic Interview (CIDI) than Mini-international Neuropsychiatric Interview (MINI); 16.96%. Moreover, the prevalence of suicidal ideation in studies with a sample size of < 400 was 23.42% whereas it was 18.3% in studies with a sample size ≥ of 400 participants. The pooled prevalence of suicidal attempts in this study was 11.06% (95% CI 6.21, 15.92). A suicidal attempt was higher in Ethiopia (16.97%) and Nigeria (16.20%) than Uganda (3.51%). This pooled prevalence of suicidal attempt was higher among studies that used a smaller sample (< 400 participants) (15.5%) than studies that used a larger sample size (≥ 400 participants) (8.4%). The pooled prevalence of suicidal attempt was 3.75%, and 16.97% in studies that used MINI and CIDI respectively. Our narrative synthesis revealed that advanced stages of AIDS, co-morbid depression, perceived HIV stigma, and poor social support was among the factors strongly associated with suicidal ideation and attempt.

Conclusion: The pooled magnitude of suicidal ideation and attempt was high and factors like advanced stages of AIDS, co-morbid depression, perceived stigma, and poor social support were related to it. Clinicians should be geared towards this mental health problem of HIV patients during management.

Keywords: Africa; Meta-analysis; Suicide.

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Conflict of interest statement

The authors of this review and meta-analytic study declared that the existed no conflict of interest for the research work.

Figures

Fig. 1
Fig. 1
PRISMA flow chart for the review search process
Fig. 2
Fig. 2
A forest plot for the prevalence of suicidal ideation in HIV/AIDS patients
Fig. 3
Fig. 3
A sub-group analysis for the prevalence of suicidal ideation
Fig. 4
Fig. 4
A forest plot for the prevalence of suicidal attempt in HIV/AIDS patients
Fig. 5
Fig. 5
A funnel plot for the prevalence of suicidal ideation in HIV/AIDS patients
Fig. 6
Fig. 6
A funnel plot for the prevalence of suicidal attempt in HIV/AIDS patients
See this image and copyright information in PMC

References

    1. Khan MM. Suicide prevention and developing countries. JR Soc Med. 2005;98:459–463. - PMC - PubMed
    1. Organization WH. Preventing suicide: a global imperative: World Health Organization; 2014.
    1. Mars B, Burrows S, Hjelmeland H, Gunnell D. Suicidal behaviour across the African continent: a review of the literature. BMC Public Health. 2014;14(1):606. - PMC - PubMed
    1. Parra-Uribe I, Blasco-Fontecilla H. Risk of re-attempts and suicide death after a suicide attempt: a survival analysis. BMC Psychiatry. 2017;17(1):163. - PMC - PubMed
    1. Turecki G, Brent DA. Suicide and suicidal behaviour. Lancet. 2016;387(10024):1227–1239. - PMC - PubMed

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