title: Risks and predictors of current suicidality in HIV-infected heroin users in treatment in Yunnan, China: a controlled study.
abstract: OBJECTIVE
  Suicide is an important public health problem in China. Elsewhere, injection drug use and HIV infection have independently been associated with suicidality, but research has often overlooked these high-risk groups in China. We determined the frequency and predictors of suicidal ideas in Chinese HIV-infected (HIV(+)) and HIV-uninfected (HIV(-)) heroin injection drug users (IDUs) in treatment and a control sample. We hypothesized that rates of suicidal ideas would be significantly higher among IDUs compared with controls and highest among HIV IDUs.
  
  
  METHODS
  We assessed suicidal ideas within the past 2 weeks in HIV(+) (n = 204) and HIV(-) (n = 202) heroin IDUs in methadone treatment in Yunnan, a province at the intersection of the heroin and HIV epidemics, and in demographically matched HIV non-drug-using controls (n = 201).
  
  
  RESULTS
  Rates of suicidality were higher in IDUs than controls, but there was no additive effect of HIV infection (HIV(+) IDU: 43.1%; HIV(-) IDU: 37.1%; controls: 8.5%). Among HIV(+) IDUs, suicidality was associated most strongly with a combination of prior history of major depression, low perceived social support, and experience of HIV-relevant stress, but not with AIDS diagnosis. Among HIV(-) IDUs, suicidality was associated with prior history of major depressive or alcohol use disorder. Less than 25% of IDUs with suicidality had histories of mood or alcohol use diagnoses.
  
  
  CONCLUSIONS
  Because suicidal ideation is frequent in IDUs in China, regardless of HIV status, and is not fully accounted for by past psychiatric history, additional research may be warranted.
authors.affiliation: HIV Neurobehavioral Research Program (HNRP), HIV Neurobehavioral Research Center, University of California San Diego, San Diego, CA 92103, USA. hjin@ucsd.edu
authors.forename: Hua
authors.initials: H
authors.lastname: Jin
authors.forename: J Hampton
authors.initials: JH
authors.lastname: Atkinson
authors.forename: Nichole A
authors.initials: NA
authors.lastname: Duarte
authors.forename: Xin
authors.initials: X
authors.lastname: Yu
authors.forename: Chuan
authors.initials: C
authors.lastname: Shi
authors.forename: Patricia K
authors.initials: PK
authors.lastname: Riggs
authors.forename: Jianhua
authors.initials: J
authors.lastname: Li
authors.forename: Saurabh
authors.initials: S
authors.lastname: Gupta
authors.forename: Tanya
authors.initials: T
authors.lastname: Wolfson
authors.forename: Adam F
authors.initials: AF
authors.lastname: Knight
authors.forename: Donald
authors.initials: D
authors.lastname: Franklin
authors.forename: Scott
authors.initials: S
authors.lastname: Letendre
authors.forename: Zunyou
authors.initials: Z
authors.lastname: Wu
authors.forename: Igor
authors.initials: I
authors.lastname: Grant
authors.forename: Robert K
authors.initials: RK
authors.lastname: Heaton
mesh_terms: D000293:Adolescent; D000328:Adult; D000704:Analysis of Variance; D016022:Case-Control Studies; D002681:China; D015331:Cohort Studies; D005260:Female; D015658:HIV Infections / Q000523:psychology*; D006556:Heroin Dependence / Q000523:psychology*; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D015819:Substance Abuse, Intravenous / Q000523:psychology; D059020:Suicidal Ideation; D055815:Young Adult