A recent European study presented at 14ª International AIDS Conference found that the suicide rate among people living with HIV in British Columbia had fallen 35 1996 times since and was already close to the level of the general population. However, a second study from Denmark found psychiatric drug use rates, especially sleeping pills and tranquilizers, about two or three times higher among people living with HIV than in the general population, and there was a large increase in antipsychotics seven or eight years after diagnosis.
Suicide rates in British Columbia
The rates of depression, anxiety and suicide are higher among people living with HIV compared to the general population. But a longitudinal research 5229 people on antiretroviral treatment (ART) in British Columbia between 1996 and 2012 found that the suicide rate decreased from 961 suicides per 100.000 patients per year (a rate of about 1% per year) for 28 by 100.000 population (below 0,03%) - an almost thirty-five fold lower rate. In 2011, the last full year of data, there were in fact no more suicides recorded in the cohort of British Columbia. Overall, there were eighty-two people (2%) died during the study period.
The 28 rate for 100.000 inhabitants is still 3 times higher than in the general population, and yet the rarest presence of suicides is even lower among people living with HIV, the greater becomes the confidence interval around the actual rate so that the "real" rate may vary considerably with this.
During the study period 17% of people with HIV (911) died of other causes other than suicide. Among the other 4318 patients in the non-varied analysis, those with less than 95% self reported ART adherence had 6,25 times more likely to commit suicide. The suicide rate declined from 23% for each increase of 100 cells / mm3CD4 and the count multiplied by more than 3 each significant increase in viral load. This line of thinking seems to support the idea that people experiencing treatment failure may be at increased suicide risk.
Suicide was also almost 4 times higher among injecting drug users even in multivariate analysis, as the presenter Jasmine Gurm the BC Centre for Excellence in HIV / AIDS noted, overdose can sometimes look like suicides and vice versa.
Other findings are more absurd, however. Among the entire group of patients, those who never had an AIDS-defining illnesses were associated with an increase of 6,6 times the suicide rate - although this can be explained in part why there are more deaths unrelated to suicide among people with AIDS . Among the 4318 who die of other causes, however, in a multivariate analysis, the suicide was 4,45 times more likely among people who had never hada AIDS-defining illnesses than among those who had.
Gurm said that people needed a certain amount of energy to commit suicide, so people who were very ill may be less likely to be able to kill, but that does not explain why after having had a diagnosis AIDS has been persistently linked with a 77% reduction in the risk of suicide. Maybe people who have had more diagnoses of AIDS-defining illnesses have received more intensive monitoring and support, or perhaps in this population, being threatened with death they had, paradoxically, something that gave him an extra motivation to live.
Psychiatric prescription in Denmark
The Danish study, also presented at the conference looked at the use of psychotropic medications - antidepressants, tranquilizers, sleeping pills, antianxiety drugs and antipsychotics in a group of HIV-positive adults 3615 the country between 1995 and 2009. He compared the prescription of drugs among 32.535 members of the general population, representing each person with HIV with 9 matched for age and sex of members of the general population.
By comparing the prescriptions of these drugs between 32.535 members of the general population, matching each person with HIV-positive members 9 corresponding by age and gender in the general population.
People with HIV were certainly prescribed more psychotropic drugs. During the observation period, the HIV-positive population received twice as many prescriptions for tranquilizers and three times more prescriptions for sleeping pills, sedatives and tranquilizers
In terms of how long people spend on various drugs, rather than aterem only to those that have been prescribed them, people living with HIV were much more likely to spend more time with antipsychotics than the general population. But they spend more time with 76% anxiolytics, 2.28 times longer with antidepressants, and 4,42 more time with sedatives and sleeping pills. Antidepressants were prescribed almost exclusively at gay men who use little more than 3 times the amount that the general population uses; use by heterosexual was not higher than average.
The researchers looked at drug use over time, starting 2 years before the diagnosis of HIV seropositivity and continuing to 10 years after diagnosis (Denmark can do this because they keep records of prescriptions for all centralized patients).
HIV positive people have had higher use rates of psychotropic drugs to the general population before their diagnosis of HIV: in the general population, in the year before diagnosis there was a 22% higher consumption of antidepressants, 68% higher in refers to anxiolytics, and twice as sedatives and sleeping pills. Editor's note: It seems to me that people already using drugs often have problems of low self-esteem and it apparently can lead to behavior "almost suicidal" that makes them put numerous times in real hazardous situations and this ends up determining the spread and at the other end of the rope, this increased "apparent" the percentage number of people with psychotropic use history. I speak of seat, since, in my personal history there are numerous situations where I put me face to face with death simply for not having my death as something very disastrous for humanity. To me missing two very important things: self love and self forgiveness. Life already almost twenty years with HIV brought me these attributes; today I love more and love life in such an intense way that, for example, I hate sleep, consider this a waste of time and to rest with dignity, I turn to the recipe of my psychiatrist, always sympathetic to my rest requirements .not out well and I would have gone mad or severely ill.
In 2 years after diagnosis, antidepressant use increased to double that in the general population and twice as high then. The use of sedatives or "sleeping pills" He doubled in the year after diagnosis, and then, was about 3 times higher than in the general population. For anxiolytic drugs, the use grew in the first year after diagnosis, but then began to fall until, in 5 6 or years after diagnosis, their use was not higher than in the general population. However, their use began to rise again 8 years after diagnosis.
The use of antipsychotics cohort of individuals serologically positive for HIV was less than the general population before the diagnosis and continued to be used in smaller or similar levels to 6 years after diagnosis. After that, its use skyrocketed, twice that in the general population. The researchers speculate that this, and the similar increase later use of anxiolytics, can track cognitive problems and yet, although the use of antipsychotics increase with time since diagnosis, this growth is not related to age. Editor's note: Subentendo this point that HIV-positive young people start with the use / abuse of these drugs still in his youth and premature aging associated with HIV infection may have an even unapproachable dynamic effect in society and (?) (?) We urge you to do something to reduce this damage.
There was no strong association between antiretroviral therapy and use of psychotropic drugs. Sedatives and antidepressants was slightly higher in people on ART, and use of anxiolytic drugs was about 25% lower, but the differences were not significant. There was no relationship between the use of efavirenz (Sustiva) and psychotropic drugs, although researchers speculated that doctors can specifically exclude people with psychological treatment with efavirenz problems.
The researcher criticized the overuse of sleeping pills and sedatives in HIV-positive patients - especially in that there is an association between drug abuse and the development of dementia related to AIDS.
Written by Gus Cairns
Translated by Claudio Souza the original Suicide Rates and Psychiatric Drug Use Among People with HIV reviewed by Mara Macedo in 12 / 08 / 2015
J Gurm, S Guillemi, and Ding, et al. Declining suicide rates Among people living with HIV (PLHIV) initiating HAART between August 1996 - June 2012 in the HAART Observational Medical Evaluation and Research cohort in British Columbia, Canada. 14th European AIDS Conference (EACS 2013). Brussels. October 16-19, 2013.Abstract PS 5 / 3.
LD Rasmussen, D Obel, Kronborg G, et al. Utilization of psychotropic drugs prescribed to persons with and without HIV infection: a Danish nationwide population-based cohort study. 14th European AIDS Conference (EACS 2013). Brussels. October 16-19, 2013.Abstract PS 5 / 4.