Suicide Rate Halves in HAART Era

A study led by an HIV expert at the University of Bern has found that suicides among Swiss AIDS patients declined by more than 50% following the introduction of highly active antiretroviral therapy in 1996.

Olivia Keiser and her team analyzed data from the Swiss HIV Cohort Study and the Swiss National Cohort, a longitudinal study of mortality in Switzerland's general population. From 1988 to 2008, 15,275 patients were followed in the SHCS for a median duration of 4.7 years. Of these, 150 died by suicide.

"In men, standardized mortality ratios declined from 13.7 in the late HAART era," the authors wrote. "In women, ratios declined from 11.6 to 5.7. In both periods suicide rates tended to be higher in older patients, in men, in injection-drug users, and in patients with advanced clinical stage of HIV illness," the researchers report. Keiser notes that 62% of those who killed themselves also had a mental illness.

The study's findings could prove significant in developing countries, where there is ongoing debate among wealthy donor nations about whether providing costly antiretrovirals is a better use of resources than inexpensive interventions like mosquito nets, antibiotics, and water filters. Asked whether she would expect to find similar results in African countries with high AIDS rates, Keiser said there is no way to know since little data exist on suicide in Africa.

Professor Lourens Schlebusch of the Nelson R. Mandela School of Medicine at the University of Natal says recent research there points to soaring suicide rates among young black South Africans in the past decade. While academic problems, incest, stress, and depression were the leading causes of suicide, Schlebusch says, people with AIDS were 36 times as likely as others to take their lives.

The study, "Suicide in HIV-Infected Individuals and the General Population in Switzerland, 1988-2008," was published in the American Journal of Psychiatry.