Abuse and HIV Status Linked to Suicide Risk

Women who are HIV-positive or are abused are more likely to think about or attempt suicide, according to a new study by researchers from the Johns Hopkins Bloomberg School of Public Health, George Washington University and St. Michael’s Hospital, in Toronto, Canada. The Hopkins study, consistent with previous research, sheds new light on the extent to which being in an abusive relationship compounds suicide risk for HIV-positive women in particular. This latest study is published in the March/April 2005 issue of Women’s Health Issues.

“Given that suicide is the fourth leading cause of death for women ages 15-44, there is a need for further research on risk and opportunities for prevention,” said Andrea C. Gielen, ScD, ScM, lead author of the study and deputy director of the Center for Injury Research and Policy at the Bloomberg School of Public Health.

The researchers used data from Project WAVE (Women, AIDS and the Violence Epidemic) to examine the rates of suicidal thoughts and attempts, as well as to gauge anxiety and depression. They also set out to learn how these outcomes differed based on women’s HIV and abuse experiences. The women were all living in low-income, urban neighborhoods in Baltimore, Md.

Of the 611 women interviewed, 31 percent reported having thought about suicide and 16 percent reported having attempted suicide. Abused women were four times more likely than non-abused women to have thought about suicide. The researchers also found that, among HIV-positive women, those recently diagnosed thought about suicide more frequently.

In addition, one-half of the study participants reported problems with depression and 26 percent reported problems with anxiety. Twenty-four percent of non-abused, HIV-negative women had problems with depression, whereas 72 percent of abused, HIV-positive women reported the same.

Abused, HIV-positive women were 7 times more likely to report problems with depression, 4.9 times more likely to have problems with anxiety, 3.6 times more likely to have thought about suicide and 12.5 times more likely to have attempted suicide, when compared to HIV-negative, non-abused women. The researchers also note that abused, HIV-negative women were at an elevated risk for depression, anxiety, suicidal thoughts and suicide attempts, indicating that the abuse is associated with the negative outcomes.

“Health care and service providers who interact with women who may be HIV-positive or are in an abusive relationship should routinely look for mental health issues, such as suicidal thoughts. It may be the case that crisis intervention is needed to help women in these situations,” said Dr. Gielen, who is also a professor in the Bloomberg School of Public Health’s Department of Health Policy and Management.

The study was supported by a grant from the National Institutes of Mental Health.

Additional co-authors of the study were Jessica Griffin Burke, PhD, MHS, Karen A. McDonnell, PhD, and Patricia J. O’Campo, PhD.