Background: Since the late 1990s, advances in HIV treatments have allowed children infected with HIV since birth (Perinatally HIV-infected individuals, PHIV) to survive into adolescence and adulthood. However, this progress comes with major challenges such as parental death, stigma, and difficulties related to disclosing serostatus, which are sometimes associated with psychological distress. Thus, the mental well-being of these youths has become a research and intervention priority. This study aimed to compare the prevalences of suicidal risk indicators among young adults (aged 18 to 25) living with PHIV to those of their uninfected peers in the general population in France.
Methods: We used data from the "CO19-Coverte" cohort of the ANRS, which included young adults (aged 18 to 25) living with PHIV (N=284), recruited between 2010 and 2015, as well as data of their peers of the same age from the cross-sectional Baromètre Santé (BS) survey of 2010 (N=2,899) conducted by Santé Publique France. Using two log-binomial regression models, we compared the prevalences of suicidal ideation and suicide attempts between the two populations, while adjusting on age and educational level in the first model. Then in the second model, on age, educational level, professional activity, living arrangements and birth country. We conducted sensitivity analysis by re-estimating the second log-binomial regression model in two ways. First, we excluded individuals born outside of France from the birth country variable. Then, in a separate model, we excluded bereaved individuals from the bereavement variable.
Results: PHIV young women were 5 times more likely to have suicidal ideation than their uninfected peers (aRR 5.1 [3.3-7.9]) and 1.8 more likely to attempt suicide than their HIV-negative peers (aRR 1.8 [1.2-2.8]). PHIV men were 4.7 times more likely to have suicidal ideation than their uninfected peers (aRR 4.7 [2.6-8.7]). However, there was no significant difference in suicide attempt among PHIV young men and among their HIV-negative peers (aRR 0.8 [0.3-2.6]). The results of the sensitivity analysis were consistent with those of the main analysis.
Conclusion: This study demonstrates that young adults living with PHIV have a higher suicidal risk compared to their uninfected peers. These findings support the need to develop, on one hand, psychological care, and on the other hand, interventions aimed at improving mental health of young adults living with HIV since childhood.