Incidence and risk factors for suicide, death due to substance use, and violent/accidental death in people with HIV
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Incidence and risk factors for suicide, death due to substance use, and violent/accidental death in people with HIV. / Tusch, Erich S.; Ryom, Lene; Fursa, Olga; Peters, Lars; Østergaard, Lars; Florence, Eric; Edwards, Simon; Hoffmann, Christian; Sambatakou, Helen; Reiss, Peter; Shahar, Eduardo; Reikvam, Dag Henrik; Schmied, Brigitte; Paduta, Dzmitry; Yakovlev, Alexei; Szlávik, János; Ranin, Jovan; Zilmer, Kai; Uždaviniene, Vilma; Pelchen-Matthews, Annegret; Mocroft, Amanda; Reekie, Joanne.
In: AIDS, Vol. 37, No. 1, 2023, p. 161-171.Research output: Contribution to journal › Journal article › Research › peer-review
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TY - JOUR
T1 - Incidence and risk factors for suicide, death due to substance use, and violent/accidental death in people with HIV
AU - Tusch, Erich S.
AU - Ryom, Lene
AU - Fursa, Olga
AU - Peters, Lars
AU - Østergaard, Lars
AU - Florence, Eric
AU - Edwards, Simon
AU - Hoffmann, Christian
AU - Sambatakou, Helen
AU - Reiss, Peter
AU - Shahar, Eduardo
AU - Reikvam, Dag Henrik
AU - Schmied, Brigitte
AU - Paduta, Dzmitry
AU - Yakovlev, Alexei
AU - Szlávik, János
AU - Ranin, Jovan
AU - Zilmer, Kai
AU - Uždaviniene, Vilma
AU - Pelchen-Matthews, Annegret
AU - Mocroft, Amanda
AU - Reekie, Joanne
N1 - Publisher Copyright: © 2023 Lippincott Williams and Wilkins. All rights reserved.
PY - 2023
Y1 - 2023
N2 - Objective:Deaths due to suicide, substance use and violence/accident may reflect similar risk factors and overlap in their classification. This study aimed to investigate incidence and risk factors of mortality among people with HIV (PWH) due to these three related causes.Design:Prospectively collected data from PWH at least 18 years old and under active follow-up in the EuroSIDA study from 2007 to 2019 were analysed.Methods:Cause-specific Cox regression analysis was used to assess risk factors.Results:A total of 17 881 participants were included, comprising 149 327 person-years of follow-up (PYFU). Forty participants died by suicide {incidence rate [IR] [95% confidence interval (CI)]: 0.3/1000 PYFU (0.2, 0.4)} 93 from substance use [IR (95% CI): 0.6/1000 PYFU (0.5, 0.8)], and 57 by violence/accident [IR (95% CI): 0.4/1000 PYFU (0.3, 0.5)]. An AIDS diagnosis within the last 12 months was associated with nine-fold increased risk of suicide vs. no history of AIDS [adjusted hazard ratio (aHR): 9.06; 95% CI: 2.07, 39.7]. Male gender was associated with double the risk of violent/accidental death (aHR: 2.28; 95% CI: 1.09, 4.78). PWH in Eastern Europe and those who acquired HIV by injection drug use (IDU) demonstrated a greater risk of death due to substance use or violence/accident.Conclusions:The association between a recent diagnosis of AIDS and suicide highlights a critical period for intervention. HIV infection acquired through IDU demonstrated an expected relationship with death due to substance use and violent/accidental deaths. Increased risk of death due to substance use and violence/accident in Eastern Europe demands investigation into specific differences that may drive that association.
AB - Objective:Deaths due to suicide, substance use and violence/accident may reflect similar risk factors and overlap in their classification. This study aimed to investigate incidence and risk factors of mortality among people with HIV (PWH) due to these three related causes.Design:Prospectively collected data from PWH at least 18 years old and under active follow-up in the EuroSIDA study from 2007 to 2019 were analysed.Methods:Cause-specific Cox regression analysis was used to assess risk factors.Results:A total of 17 881 participants were included, comprising 149 327 person-years of follow-up (PYFU). Forty participants died by suicide {incidence rate [IR] [95% confidence interval (CI)]: 0.3/1000 PYFU (0.2, 0.4)} 93 from substance use [IR (95% CI): 0.6/1000 PYFU (0.5, 0.8)], and 57 by violence/accident [IR (95% CI): 0.4/1000 PYFU (0.3, 0.5)]. An AIDS diagnosis within the last 12 months was associated with nine-fold increased risk of suicide vs. no history of AIDS [adjusted hazard ratio (aHR): 9.06; 95% CI: 2.07, 39.7]. Male gender was associated with double the risk of violent/accidental death (aHR: 2.28; 95% CI: 1.09, 4.78). PWH in Eastern Europe and those who acquired HIV by injection drug use (IDU) demonstrated a greater risk of death due to substance use or violence/accident.Conclusions:The association between a recent diagnosis of AIDS and suicide highlights a critical period for intervention. HIV infection acquired through IDU demonstrated an expected relationship with death due to substance use and violent/accidental deaths. Increased risk of death due to substance use and violence/accident in Eastern Europe demands investigation into specific differences that may drive that association.
KW - HIV
KW - mortality
KW - substance use
KW - suicide
KW - violent/accidental death
U2 - 10.1097/QAD.0000000000003402
DO - 10.1097/QAD.0000000000003402
M3 - Journal article
C2 - 36250262
AN - SCOPUS:85143644501
VL - 37
SP - 161
EP - 171
JO - AIDS
JF - AIDS
SN - 1350-2840
IS - 1
ER -
ID: 397163331