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In Botswana, there is a lack of data needed to provide comprehensive care for this group. This study aimed to compare rates and predictors of suicidal ideation (SI) and attempts (SA) between substance users and non-users among YLWHIV at Botswana-Baylor Children\u2019s Clinical Centre of Excellence (BBCCCE).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>This cross-sectional study, conducted from August 2022 to January 2023, involved 255 participants aged 15 to 24 and used the Youth Risk Behavior Surveillance System, the Oslo Social Support Scale, and the Patient Health Questionnaire-9. Chi-square tests were used to compare the prevalence of suicidal ideation and attempts among substance users and non-users, while logistic regression was used to identify factors associated with SI and SA.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>SI was found in 29.4%, SA in 6%, and depression in 39.6% of the participants, while tobacco, alcohol, and illicit drug use were 20.4%, 45.9%, and 11.8%. Depression (adjusted odds ratios [AOR] 9.71, 95% CI: 4.23-22.33), being bullied (AOR\u2009=\u20095.42, 95% CI:\u20091.97-14.91), and family history of completed suicide (AOR\u2009=\u20096.56, 95% CI:\u20091.16-37.12) were associated with the outcome, SI. Self-reported good health status (AOR\u2009=\u20090.23, 95% CI: 0.05-0.98), lack of family support (AOR\u2009=\u20095.92, 95% CI: 1.45-24.10), and past-year tobacco use (AOR\u2009=\u20097.37, 95%\u2009CI:\u20091.18-46.10) were associated with SA.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>Due to the high rates of suicidal behavior among YLWHIV in BBCCCE, health facilities should scale up mental health services for this vulnerable group. This includes suicide risk assessments, bullying prevention, depression screenings, and counseling by trained lay health workers to promote their mental well-being.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/29768357251327567","type":"journal-article","created":{"date-parts":[[2025,3,27]],"date-time":"2025-03-27T18:54:25Z","timestamp":1743101665000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Suicidal Ideation and Attempts Among Youth Living With HIV\/AIDS Attending Botswana-Baylor Children\u2019s Clinical Centre of Excellence: A Comparison Between Substance Users and Non-Substance Users"],"prefix":"10.1177","volume":"19","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6760-3872","authenticated-orcid":false,"given":"Leyla","family":"Baghirova-Busang","sequence":"first","affiliation":[{"name":"Department of Family Medicine and Public Health, University of Botswana, Gaborone, Botswana"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anthony A","family":"Olashore","sequence":"additional","affiliation":[{"name":"Department of Psychiatry, Gaborone, University of Botswana, Botswana"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mogomotsi","family":"Matshaba","sequence":"additional","affiliation":[{"name":"Botswana-Baylor Children\u2019s Clinical Centre of Excellence, Gaborone, Botswana"},{"name":"Department of Pediatrics, Baylor College of Medicine, Houston, TX, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mooketsi","family":"Molefi","sequence":"additional","affiliation":[{"name":"Department of Family Medicine and Public Health, University of Botswana, Gaborone, Botswana"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2025,3,27]]},"reference":[{"key":"e_1_3_3_2_2","unstructured":"World Health Organization. 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