Suicide risk and mental health indicators: Do they differ by abuse and HIV status?


      This study examines the association between women’s HIV serostatus, intimate partner violence (IPV) experience, and risk of suicide and other mental health indicators. Using data from Project WAVE (Women, AIDS, and the Violence Epidemic), we 1) describe the rates of suicidal thoughts and attempts, anxiety, and depression; 2) examine whether and to what extent these outcomes differ by women’s HIV and IPV status.


      A one-time interview was conducted with a sample 611 women living in an urban area, one-half of whom were HIV-positive.


      Having thought about suicide was reported by 31% of the sample and 16% reported having attempted suicide. Among HIV-positive women, thoughts of suicide occurred more frequently among those who were recently diagnosed. One-half of the sample reported problems with depression, and 26% reported problems with anxiety; of women reporting these problems, 56% received mental health treatment. Rates varied significantly by HIV and IPV status, with women who were both HIV-positive and abused consistently faring worse. Relative to HIV-negative nonabused women, HIV-positive abused women were 7.0 times as likely to report problems with depression, 4.9 times as likely to report problems with anxiety, 3.6 times as likely to have thought about suicide, and 12.5 times as likely to have ever attempted suicide. Our findings that abused HIV-negative women were also at significantly elevated risk for all of these outcomes lends support to the conclusion that it is the experience of abuse that is associated with the negative outcomes.


      Health care and service providers interacting with women who may be HIV-positive and/or in abusive relationships should routinely assess for mental health status, especially suicide risk, which may need crisis intervention.
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      Dr. Andrea Carlson Gielen is Professor of social and behavioral sciences and Deputy Director of the Center for Injury Research and Policy at the Johns Hopkins Bloomberg School of Public Health. She is a health educator whose research is focused on behavior change interventions addressing injuries among women and children in low-income urban settings.


      Dr. Karen A McDonnell is Assistant Professor of maternal and child health at the George Washington University, School of Public Health and Health Sciences. She is a health psychologist who studies quality of life and psychosocial adjustment among women and children, with an emphasis on injury problems affecting low-income families and the development and evaluation of interventions.


      Dr. Jessica Griffin Burke is a research associate in the department of Population and Family Health Sciences at the Johns Hopkins Bloomberg School of Public Health. She is a social scientist whose research examines the multiple levels of risk and protective factors influencing women’s health, including the relationship between neighborhood context and intimate partner violence.


      Dr. Patricia O’Campo is Alma and Baxter Ricard Endowed Chair in Inner City Health and Director of the Centre for Research on Inner City Health. She is a social epidemiologist whose research is focused on social inequalities in health.