{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,22]],"date-time":"2026-04-22T23:39:23Z","timestamp":1776901163736,"version":"3.51.2"},"reference-count":24,"publisher":"Public Library of Science (PLoS)","issue":"8","license":[{"start":{"date-parts":[[2021,8,20]],"date-time":"2021-08-20T00:00:00Z","timestamp":1629417600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/publicdomain\/zero\/1.0\/"}],"funder":[{"DOI":"10.13039\/501100001713","name":"European and Developing Countries Clinical Trials Partnership","doi-asserted-by":"publisher","award":["TA.2010.40200.011"],"award-info":[{"award-number":["TA.2010.40200.011"]}],"id":[{"id":"10.13039\/501100001713","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS ONE"],"abstract":"<jats:sec id=\"sec001\">\n<jats:title>Introduction<\/jats:title>\n<jats:p>Suicidality is a risk of a person committing suicide often characterized by suicidal ideation, intent or attempts. Despite the high burden of suicidality among individuals living with HIV and HAIDS, there is paucity of data on the impact of suicidality on clinical (such as CD4 counts and HIV disease progression) and behavioural outcomes (such as adherence to HIV Medications). Cross-sectional investigations of these associations are often complicated by bidirectional causal relationships and hence the need for longitudinal study designs. We conducted a cohort study to determine the impact of suicidality on clinical and behavioural outcomes among adults living with HIV\/AIDS in Uganda.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec002\">\n<jats:title>Materials and methods<\/jats:title>\n<jats:p>We conducted the study among 1099 ART na\u00efve adults living with HIV\/AIDS in Uganda. Data were collected at three time points: baseline, 6 and 12 months. Multiple regression and discrete time survival models were used to determine the relationship between suicidality and indices of HIV outcomes.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec003\">\n<jats:title>Results<\/jats:title>\n<jats:p>Majority of the participants were female and the participant mean age was 35 years. Most of them (73%) had primary or no formal education. The proportion of participants with suicidality decreased from 2.9% at baseline to roughly 1% both at month 6 and month 12. Of the investigated clinical and behavioural outcomes, baseline suicidality only had a negative impact on missing a dose of ART where the odds of missing a dose of ART were 8.25 (95% CI 2.45\u201327.71, p&gt;0.01) times higher for participants with suicidality compared to those without suicidality. The following outcomes were not significantly impacted by baseline suicidality: HIV clinical stage, CD4 count and risky sexual behaviour.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec004\">\n<jats:title>Conclusions<\/jats:title>\n<jats:p>The fact that baseline suicidality significantly negatively impacted ART adherence calls for the incorporation of psychosocial interventions to target indices of psychological distress such as suicidality to improve HIV related outcomes.<\/jats:p>\n<\/jats:sec>","DOI":"10.1371\/journal.pone.0254830","type":"journal-article","created":{"date-parts":[[2021,8,20]],"date-time":"2021-08-20T18:24:32Z","timestamp":1629483872000},"page":"e0254830","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":5,"title":["Effect of suicidality on clinical and behavioural outcomes in HIV positive adults in Uganda"],"prefix":"10.1371","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3739-1426","authenticated-orcid":true,"given":"Godfrey Zari","family":"Rukundo","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jonathan","family":"Levin","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Richard Stephen","family":"Mpango","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Vikram","family":"Patel","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Eugene","family":"Kinyanda","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"340","published-online":{"date-parts":[[2021,8,20]]},"reference":[{"key":"pone.0254830.ref001","doi-asserted-by":"crossref","first-page":"307","DOI":"10.1146\/annurev-clinpsy-021815-093204","article-title":"Suicide, Suicide Attempts, and Suicidal Ideation","volume":"12","author":"ED Klonsky","year":"2016","journal-title":"Annu Rev Clin Psychol"},{"issue":"1","key":"pone.0254830.ref002","doi-asserted-by":"crossref","first-page":"38","DOI":"10.1027\/0227-5910.29.1.38","article-title":"The impact of suicide on the family","volume":"29","author":"J Cerel","year":"2008","journal-title":"Crisis"},{"issue":"2","key":"pone.0254830.ref003","doi-asserted-by":"crossref","first-page":"e0171645","DOI":"10.1371\/journal.pone.0171645","article-title":"Suicide risk in a representative sample of people receiving HIV care: Time to target most-at-risk populations (ANRS VESPA2 French national survey)","volume":"12","author":"MP Carrieri","year":"2017","journal-title":"PLoS One"},{"issue":"2","key":"pone.0254830.ref004","doi-asserted-by":"crossref","first-page":"E140","DOI":"10.9778\/cmajo.20140101","article-title":"Suicide mortality among people accessing highly active antiretroviral therapy for HIV\/AIDS in British Columbia: a retrospective analysis","volume":"3","author":"J Gurm","year":"2015","journal-title":"CMAJ Open"},{"issue":"2","key":"pone.0254830.ref005","doi-asserted-by":"crossref","first-page":"143","DOI":"10.1176\/appi.ajp.2009.09050651","article-title":"Suicide in HIV-infected individuals and the general population in Switzerland, 1988\u20132008","volume":"167","author":"O Keiser","year":"2010","journal-title":"Am J Psychiatry"},{"issue":"2","key":"pone.0254830.ref006","doi-asserted-by":"crossref","first-page":"136","DOI":"10.1097\/QAI.0000000000001647","article-title":"Major Depressive Disorder: Longitudinal Analysis of Impact on Clinical and Behavioral Outcomes in Uganda","volume":"78","author":"E Kinyanda","year":"2018","journal-title":"J Acquir Immune Defic Syndr"},{"issue":"11","key":"pone.0254830.ref007","doi-asserted-by":"crossref","first-page":"1379","DOI":"10.1080\/09540121.2014.913767","article-title":"High prevalence of suicide risk in people living with HIV: who is at higher risk?","volume":"26","author":"SM Passos","year":"2014","journal-title":"AIDS Care"},{"key":"pone.0254830.ref008","first-page":"609172","article-title":"Elevated Risk of Suicidal Ideation in HIV-Positive Persons","volume":"2015","author":"L Schlebusch","year":"2015","journal-title":"Depress Res Treat"},{"key":"pone.0254830.ref009","unstructured":"TASO. 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