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. 2024 Sep 10:15:1361304.
doi: 10.3389/fpsyt.2024.1361304. eCollection 2024.

Suicidal ideation and associated factors among people living with HIV/AIDS in Ethiopia: a systematic review and meta-analysis

Amanuel Yosef Gebrekidan  1 , Afework Alemu Lombebo  2 , Amelework Gonfa Efa  2 , Gedion Asnake Azeze  3 , Gizachew Ambaw Kassie  1 , Kirubel Eshetu Haile  4 , Yordanos Sisay Asgedom  1 , Beshada Zerfu Woldegeorgis  5 , Tadesse Asmamaw Dejenie  6
Affiliations

Suicidal ideation and associated factors among people living with HIV/AIDS in Ethiopia: a systematic review and meta-analysis

Amanuel Yosef Gebrekidan et al. Front Psychiatry. .

Abstract

Background: Suicide is one of the main causes of mortality in the world, accounting for more fatalities than homicide, war, human immunodeficiency virus (HIV)/acquired immunodeficiency syndrome (AIDS), breast cancer, and malaria. Significantly, the biggest risk factors for suicide in the general population are having already attempted suicide and suicidal ideation. Despite the availability of studies on suicidal ideation among people living with HIV/AIDS (PLWHA) in Ethiopia, the results are inconsistent. Thus, a systematic review and meta-analysis was conducted to estimate the pooled prevalence of suicidal ideation among people living with HIV/AIDS.

Methods: A systematic review and meta-analysis was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guideline. To find papers published in the English language before 20 May 2023, the electronic databases of Medline, Science Direct, Excerpta Medica Database, Cochrane Library, African Journals Online (AJOL), and Google Scholar were searched. The DerSimonian and Laird method for random effects models was used to estimate the pooled prevalence of suicidal ideation with a 95% confidence interval in STATA V.14.0 statistical software. To test for heterogeneity between studies and publication bias, respectively, forest plots and funnel plots were used. Additionally, leave-one-out sensitivity was conducted.

Results: A total of nine studies with 3,411 study participants were included in this systematic review and meta-analysis. The pooled prevalence of suicidal ideation among PLWHA was 20.55% (95% CI 14.76, 26.33). Being female (Odds ratio (OR) = 4.27, 95% CI = 2.29, 7.97), living alone (OR = 5.02, 95% CI = 2.15, 11.64), poor social support (OR = 3.80, 95% CI = 2.56, 5.65), perceived stigma (OR = 3.50, 95% CI = 1.55, 7.87), depression (OR = 5.08, 95% CI = 2.55, 11.48), undisclosed HIV status (OR = 4.8, 95% CI = 2.10, 10.93), and World Health Organization HIV clinical stages of III or IV (OR = 4.40, 95% CI = 2.95, 6.58) were significantly associated with suicidal ideation.

Conclusion: Suicidal ideation among PLWHA is high in Ethiopia. Therefore, emphasis should be given to psychiatric assessment and interventions with a special focus on individuals having the associated factors.

Systematic review registration: PROSPERO (CRD42023429613).

Keywords: AIDS; Ethiopia; HIV; suicidal ideation; suicide.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
PRISMA flow diagram of the selection process of studies on suicidal ideation among PLWHA in Ethiopia.
Figure 2
Figure 2
Forest plot of the pooled prevalence in the systematic review and meta-analysis of suicidal ideation among PLWHA in Ethiopia.
Figure 3
Figure 3
Subgroup analysis based on study area (region) in the systematic review and meta-analysis of suicidal ideation among PLWHA in Ethiopia.
Figure 4
Figure 4
Funnel plot of publication bias in the systematic review and meta-analysis of suicidal ideation among PLWHA in Ethiopia.
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