Date of Award
Spring 2023
Document Type
Dissertation
Degree Name
Doctor of Philosophy (PhD)
Department
Public Health
First Advisor
Womack, Julie
Abstract
With advancements in treatment, HIV has transitioned from a terminal diagnosis to a chronic illness. Yet, despite improvement in life expectancy, people living with HIV (PWH) remain at high risk of suicide compared to the general population [1-8]. Moreover, the risk of suicide among PWH is greater compared to individuals with other chronic conditions [9]. Given the persistently elevated rate of suicide among PWH, the goal of this dissertation is to further advance our knowledge of risk factors contributing to suicide among PWH. For this dissertation, I first reviewed the existing peer-reviewed literature from 1996 through 2020 and identified known risk factors and gaps in knowledge. Second, I examined demographic, psychiatric, physiologic, and HIV-specific risk factors for suicide in the Veterans Aging Cohort Study (VACS) from 2006-2015. Third, I expanded on these findings and explored associations with self-injurious unnatural death (SIUD) that included deaths from intentional, unintentional, or undetermined forms of self-injurious behavior and examined risk factors for SIUD among PWH. In summary, my dissertation research evaluated the following: Aim 1: Explore risk factors for suicide among people with HIV, synthesize the current literature, and identify gaps in our knowledge. Aim 2: Compare risk factors for suicide amongst Veterans living with HIV and risk factors for suicide among Veterans living without HIV using stratified models. Aim 3: Examine whether inclusion of HIV-specific risk factors (viral load, CD4 count, and antiretroviral therapy [ART]) independently contribute to the risk of suicide among Veterans living with HIV. Aim 4: Expand the outcome to self-injurious unnatural death (SIUD) and compare risk factors associated with SIUD to risk factors associated with suicide among PWH.
Recommended Citation
Smith, Alexandria Catherine, "Risk Factors Associated with Suicide Among Veterans with HIV in the Veterans Aging Cohort Study" (2023). Yale Graduate School of Arts and Sciences Dissertations. 1056.
https://elischolar.library.yale.edu/gsas_dissertations/1056
