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Title
Suicidal behaviors among Thai adolescents and young adults living with HIV
Presenter
Tavitiya Sudjaritruk
Authors
T. Sudjaritruk1,2, O. Mueangmo1,2, J. Saheng1,2, W. Wongjak2, T. Chaito2, P. Nantarat2, J.L. Ross3, A.H. Sohn3, C.A. Mellins4,5
Institutions
1Faculty of Medicine, Chiang Mai University, Department of Pediatrics, Chiang Mai, Thailand, 2Faculty of Medicine, Chiang Mai University, Clinical and Molecular Epidemiology of Emerging and Re-emerging Infectious Diseases Research Cluster, Chiang Mai, Thailand, 3TREAT Asia/amfAR, The Foundation for AIDS Research, Bangkok, Thailand, 4NY State Psychiatric Institute, HIV Center for Clinical and Behavioral Studies, New York City, United States, 5Columbia University, New York City, United States

BACKGROUND: Suicide is the fourth leading cause of death in adolescents and young adults worldwide. Suicidality can negatively impact quality of life and HIV treatment outcomes. This study aimed to describe suicidal ideation and behaviors among Thai adolescents and young adults living with HIV (AYA-HIV).
METHODS: A cross-sectional study was conducted among Thai AYA-HIV aged 15-24 years who were aware of their HIV status, and attended an HIV clinic in Chiang Mai, Thailand. Participants were interviewed about lifetime and recent suicidal ideation and behaviors by well-trained staff, using a cross-culturally validated Thai version of the Columbia-Suicide Severity Rating Scale (C-SSRS). The C-SSRS’s questions are divided into 4 subscales: (1) suicidal ideation; (2) intensity of ideation; (3) suicidal behaviors; (4) lethality of suicide attempts.
RESULTS: Of 150 AYA-HIV enrolled, 101 (67%) were male, 90 (60%) had perinatally acquired HIV, 85 (57%) were heterosexual, and the median age was 21 (interquartile range [IQR]: 19-23) years. At enrollment, 66 (45%) had graduated with bachelor degree or higher, and 126 (84%) had monthly incomes <500 USD. All AYA-HIV were on combination antiretroviral treatment (cART), of which 70% of regimens included non-nucleoside reverse transcriptase inhibitor, and the median self-reported adherence to cART was 95% (IQR: 90-100%). The median CD4 count was 547 (IQR: 378-747) cells/mm3; 79% had viral load <50 copies/mL.

Overall, 44 (29%) AYA-HIV reported lifetime suicidal ideation, 8 of whom (18%) reported symptoms within the past month. Additionally, 16 (11%) AYA-HIV reported having suicidal behaviors during their lifetime, 2 (13%) within the previous 3 months. The characteristics of suicidal ideation and behaviors among our Thai AYA-HIV are summarized in Table 1.


CONCLUSIONS: Suicidal ideation and behaviors were prevalent in Thai AYA-HIV in our study cohort. Screening for suicidality in primary HIV clinics could help with earlier detection and linkage to appropriate management for this population.

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