People With HIV at Much Higher Risk of Depression, Suicide

People living with HIV (PLWH) are at a much higher risk of developing depression, taking antidepressants, undergoing electroconvulsive therapy (ECT), and committing suicide than their counterparts without HIV, especially in the first 2 years after receiving an HIV diagnosis.

This news comes from a press release based on abstract 2666 presented at this year’s European Congress of Clinical Microbiology & Infectious Diseases annual meeting, which was held in Copenhagen, Denmark, April 15-18.

Previous studies have suggested that HIV may be associated with depression, but results have been inconclusive, and no prior studies have assessed whether familial factors could influence the link between HIV and depression.

To better understand these points of interest, researchers used Denmark’s national health registers to analyze records of depression—including depression diagnoses, use of antidepressants, ECT receipt, and suicide—of 5943 individuals diagnosed with HIV between 1995 and 2021. They compared PLWH’s risk of depression with 59,430 controls without HIV from the general population, matched by age and sex.

The researchers found that PLWH had double the risk of depression and treatment with ECT, 1.5 times greater risk of antidepressant use, and 3.5 times increased risk of committing suicide, compared with people without HIV.

These risks were much higher in the 2 years after diagnosis. During that time frame, PLWH were about 3 times more likely to develop depression, use antidepressants, and undergo ECT, and they were 10 times more likely to commit suicide.

According to Lars Omland, MD, PhD, Copenhagen University, lead author of the study, the levels of depression among PLWH were much higher than he expected.

“Our findings clearly highlight the serious mental health implications of being given a diagnosis of HIV and the importance of clinicians looking out for symptoms of depression in this high-risk population,” Omland said. “Caring for people with HIV, which has traditionally focused on their physical health, should place more emphasis on their mental health.”

The researchers also compared the annual percentage of individuals utilizing psychiatric hospitals to treat their depression and use of antidepressants in the decade before and after the study inclusion. After doing so, they discovered an increased percentage of psychiatric hospital usage, prior to but also particularly after HIV diagnosis, among PLWH.

For example, 2 years prior to study inclusion, 6.4% of PLWH used antidepressants, which was 1.2% more than the control group. Two years after study inclusion, this difference increased to 3.1%.

The researchers also compared the risks between 5807 siblings of PLWH and 82,411 siblings of controls. Notably, siblings of PLWH also experienced an elevated risk of depression diagnosis, antidepressant use, and suicide compared with the general population, but their risk was still lower than that of PLWH. According to the researchers, this implies that factors related to family are unlikely to account for the higher risk seen among PLWH.

“The higher risk of developing depression and suicide in both people living with HIV and their siblings is very troubling, and we need to dig deeper to understand the causes,” said Omland. “One potential explanation for the increased risk of depression and suicide among siblings of people living with HIV could be stress and stigma related to a loved one being diagnosed with a chronic disease. It’s also possible that risk factors for depression and HIV-infection overlap.”

As this study was observational, the authors noted they cannot rule out the possibility that other unmeasured factors, such as alcohol and illicit drug use, or confounding factors not controlled for could have impacted the results. Additionally, as the study was conducted in Denmark, these results are not necessarily applicable to all populations.

There is no full paper or poster available at the time of publication.