Prevalence and Determinants of Suicidal Ideation and Suicide Attempt in People With Human Immunodeficiency Virus in Africa: a Systematic Review.

Background: People with human immunodeficiency virus (HIV) are at higher risk of suicidal ideation and suicide attempts. We reviewed the literature for the prevalence and determinants of suicidal ideation and suicide attempt in people with HIV in Africa.

Methods: The PubMed, Scopus, and Google scholar were searched for original studies published in peer-reviewed journals in English language between January 2015 to July 2020, using the key words: 'suicidal behavior', 'suicidal attempt', 'suicidal ideation', 'HIV/AIDS', and/or 'Africa'. The quality of included studies was assessed using the Newcastle-Ottawa scale.

Results: 12 cross-sectional studies published in the past 5 years in African countries were included. The quality of studies was high, with score ranging from 6 to 9. The prevalence of suicidal ideation ranged from 8.8% to 39%. The prevalence of suicide attempt ranged from 2.8% to 20.1%. The most common risk factors for suicidal behaviour were mental health-related problems. Other factors included high clinical stage of HIV, being unmarried, poor medication adherence, poorer quality of life, not taking highly active antiretroviral therapy, female sex, no education, substance use, low CD4 level, and opportunistic infection.

Conclusion: Patients with HIV/AIDS have an increased risk of suicidal ideation and suicide attempts. Early screening, treatment, and referral of suicidal patients are necessary for HIV clinics.