title: Suicide risk in a representative sample of people receiving HIV care: Time to target most-at-risk populations (ANRS VESPA2 French national survey).
abstract: BACKGROUND
  Suicide risk is high among people living with HIV (PLHIV). This study aimed to identify major correlates of suicide risk in a representative sample of PLHIV in France, in order to help target individuals who would benefit from suicide risk screening and psychiatric care.
  
  
  METHODS
  The ANRS VESPA2 cross-sectional survey (April 2011-January 2012) collected socio-demographic, medical and behavioral data from 3,022 PLHIV recruited in 73 French HIV hospital departments. The study sample comprised the 2,973 participants with available self-reported data on suicide risk (defined as having either thought about and planned to commit suicide during the previous 12 months or attempted suicide during the same period of time) and medical data on comorbidities. Weighted Poisson models adjusted for HCV co-infection and significant clinical variables were used to estimate the relationship between suicide risk and HIV transmission groups, experience with HIV disease and other psychosocial factors.
  
  
  RESULTS
  Suicide risk was reported by 6.3% of PLHIV in the study sample. After adjustment for HIV immunological status and HCV co-infection, women (IRR [95%CI]:1.93 [1.17; 3.19]) and men who have sex with men (MSM) (1.97 [1.22; 3.19]) had a higher suicide risk than the rest of the sample. Moreover, the number of discrimination-related social contexts reported (1.39 [1.19; 1.61]), homelessness (4.87 [1.82; 13.02]), and reporting a feeling of loneliness (4.62 [3.06; 6.97]) were major predictors of suicide risk.
  
  
  CONCLUSIONS
  Reducing the burden of precarious social conditions and discrimination is an important lever for preventing suicide risk among PLHIV in France. Comprehensive care models involving peer/community social interventions targeted at women and MSM need to be implemented to lower the risk of suicide in these specific subgroups of PLHIV.
authors.affiliation: Aix Marseille Univ, INSERM, IRD, SESSTIM, Sciences Economiques & Sociales de la Santé & Traitement de l'Information Médicale, Marseille, France.|ORS PACA, Observatoire régional de la santé Provence-Alpes-Côte d'Azur, Marseille, France.
authors.forename: Maria Patrizia
authors.initials: MP
authors.lastname: Carrieri
authors.affiliation: Aix Marseille Univ, INSERM, IRD, SESSTIM, Sciences Economiques & Sociales de la Santé & Traitement de l'Information Médicale, Marseille, France.|ORS PACA, Observatoire régional de la santé Provence-Alpes-Côte d'Azur, Marseille, France.
authors.forename: Fabienne
authors.identifier: http://orcid.org/0000-0001-8853-3829
authors.initials: F
authors.lastname: Marcellin
authors.affiliation: Aix Marseille Univ, INSERM, IRD, SESSTIM, Sciences Economiques & Sociales de la Santé & Traitement de l'Information Médicale, Marseille, France.|ORS PACA, Observatoire régional de la santé Provence-Alpes-Côte d'Azur, Marseille, France.
authors.forename: Lisa
authors.initials: L
authors.lastname: Fressard
authors.affiliation: Aix Marseille Univ, INSERM, IRD, SESSTIM, Sciences Economiques & Sociales de la Santé & Traitement de l'Information Médicale, Marseille, France.|GREPS, Psychology Institute, Lyon 2 University, 5 avenue Pierre Mendes-France, Bron, France.
authors.forename: Marie
authors.initials: M
authors.lastname: Préau
authors.affiliation: Aix Marseille Univ, INSERM, IRD, SESSTIM, Sciences Economiques & Sociales de la Santé & Traitement de l'Information Médicale, Marseille, France.|ORS PACA, Observatoire régional de la santé Provence-Alpes-Côte d'Azur, Marseille, France.
authors.forename: Luis
authors.initials: L
authors.lastname: Sagaon-Teyssier
authors.affiliation: Aix Marseille Univ, INSERM, IRD, SESSTIM, Sciences Economiques & Sociales de la Santé & Traitement de l'Information Médicale, Marseille, France.|ORS PACA, Observatoire régional de la santé Provence-Alpes-Côte d'Azur, Marseille, France.
authors.forename: Marie
authors.initials: M
authors.lastname: Suzan-Monti
authors.affiliation: Aix Marseille Univ, INSERM, IRD, SESSTIM, Sciences Economiques & Sociales de la Santé & Traitement de l'Information Médicale, Marseille, France.|ORS PACA, Observatoire régional de la santé Provence-Alpes-Côte d'Azur, Marseille, France.
authors.forename: Valérie
authors.initials: V
authors.lastname: Guagliardo
authors.affiliation: Aix Marseille Univ, INSERM, IRD, SESSTIM, Sciences Economiques & Sociales de la Santé & Traitement de l'Information Médicale, Marseille, France.|ORS PACA, Observatoire régional de la santé Provence-Alpes-Côte d'Azur, Marseille, France.
authors.forename: Marion
authors.initials: M
authors.lastname: Mora
authors.affiliation: Aix Marseille Univ, INSERM, IRD, SESSTIM, Sciences Economiques & Sociales de la Santé & Traitement de l'Information Médicale, Marseille, France.|ORS PACA, Observatoire régional de la santé Provence-Alpes-Côte d'Azur, Marseille, France.
authors.forename: Perrine
authors.initials: P
authors.lastname: Roux
authors.affiliation: INSERM, UMR_S1136, Pierre Louis Institute of Epidemiology and Public Health, Team Research in social epidemiology, Paris, France.|Sorbonne Universités, UPMC Univ Paris 06, UMR_S1136, Pierre Louis Institute of Epidemiology and Public Health, Team Research in social epidemiology, Paris, France.
authors.forename: Rosemary
authors.initials: R
authors.lastname: Dray-Spira
authors.affiliation: Aix Marseille Univ, INSERM, IRD, SESSTIM, Sciences Economiques & Sociales de la Santé & Traitement de l'Information Médicale, Marseille, France.|ORS PACA, Observatoire régional de la santé Provence-Alpes-Côte d'Azur, Marseille, France.
authors.forename: Bruno
authors.initials: B
authors.lastname: Spire
mesh_terms: D000293:Adolescent; D000328:Adult; D015897:Comorbidity; D003430:Cross-Sectional Studies; D005260:Female; D005602:France / Q000453:epidemiology; D015658:HIV Infections / Q000188:drug therapy* / Q000453:epidemiology / Q000821:virology; D006306:Health Surveys / Q000379:methods / Q000706:statistics & numerical data*; D006526:Hepatitis C / Q000453:epidemiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D016012:Poisson Distribution; D012044:Regression Analysis; D012307:Risk Factors; D013405:Suicide / Q000706:statistics & numerical data*; D013406:Suicide, Attempted / Q000706:statistics & numerical data*; D055815:Young Adult