Sharp Decline in HIVer Suicides

A nationwide study found that suicide rates for HIV patients in Switzerland decreased by more than half after 1996, when highly active antiretroviral therapy was introduced. Despite the dramatic decrease, the suicide rate among HIV-infected individuals still significantly exceeded that of the general population.

The study also showed that the majority of HIV patients who died by suicide (62%) had a mental illness diagnosis.

The findings from this nationwide Swiss study by Olivia Keiser, Ph.D., and colleagues from the University of Bern released December 15 at AJP in Advance, the online advance of The American Journal of Psychiatry.

Keiser and a team found that the reduction in suicide risk after the introduction of antiretroviral therapy was associated with an increase in CD4 cells, indicating an improvement in HIV disease status. In the pre-HAART era high suicide rates were driven by disease progression, which at that time could not be prevented.

Although suicide rates have declined, there still remains a serious public-health concern that HIV patients are not receiving proper mental health treatment. Substantial proportions of HIV patients -- both before and after antiretroviral therapy was introduced -- had not been treated for their mental condition.

"HAART is not a cure," Keiser explains. "Even though the rates of suicide and untreated mental illness in HIV patients have declined, they're both still high and warrant increases in mental health screening and access to pharmacological and psychological treatment for these patients."

Data was provided by the Swiss National Cohort and the Swiss HIV Cohort Study, which are funded by the Swiss National Science Foundation. The Swiss HIV Cohort Study is one of the oldest HIV cohort studies worldwide and includes about 40% of all HIV-positive patients in Switzerland and about 70% of all patients with AIDS.