Magnitude and determinants of suicidality among HIV positive outpatients in Mbeya city

Abstract

Background: Globally 33.3 million people were estimated to be living with HIV/AIDS at the end of the year 2009 compared to 33.4 million at the end of the year 2008. Sub Saharan Africa continues to bear the greatest share in global burden of HIV/AIDS, even though the rates of new HIV infections are declining, the total number of people living with HIV/AIDS keeps on rising. As a result of increasing awareness and utilization of HIV related care the prevalence of HIV has declined since the year 2000 but has stabilized in East African countries. The incidence slowed down in Tanzania to about 3.4 per 1000 person- years from 2004 to 2008. Studies have highlighted high rates of depression and suicidality among HIV patients. Depression and HIV+ status independently predict poor daily functioning. Studies have reported suicidal ideation rate of 34.7% among PLHA compared to 4% of the controls while 9.3% had suicide attempt compared to 2% of the controls. Objectives: This study aimed at determining physical and mental health factors related to suicidality among HIV positive outpatients attending care and treatment clinic in Mbeya city. Materials and methods: This was analytical cross sectional study in which 597 HIV patients were recruited from four different health facilities through systematic random sampling. Four health facilities located close to the town center were involved; one referral hospital, one regional hospital and two the health centers. Sociodemographic structured questionnaire was used to collect information. The sample included males and females aged 18 years and above. The consent was obtained before recruitment to participate in the study. Data was analyzed using SPSS version 17. Bivariate and binary logistic regressions were employed to draw inferences with regard to independent variables and suicidality. vii Results: Among 597 participants, 219(37.7%) were males and 378(63.3%) were females. The mean age was 39.19 years (SD= 10.77). Rate of suicidality was found to be 8.9% suicidal thoughts, 3.2% suicide plan and 2.2% suicide attempts. Suicidality was independently associated with depression (OR=2.09, 95%CI=1.17-3.73, p=0.01 and stigma (OR=2.94, 95%CI=1.64-5.28, p<0.01). Conclusion and recommendation: This research suggests suicidality was prevalent among HIV positive out patients in Mbeya city. This calls for the comprehensive assessment, treatment and referral for suicidality as a component of mental health programs among HIV outpatient’s clinics.