Self-injury and suicide among people living with HIV/AIDS in China: a systematic review and meta-analysis.

Background: The prevalence of self-injury and suicide is higher than the general population of people living with HIV/AIDS (PLWHA). However, the results reported in existing studies are highly variable in China. The purpose of this systematic review and meta-analysis was to synthesize the currently available high-quality evidence to explore the prevalence and influence factors of self-injury and suicide among PLWHA in China. Method: We retrieve literature written in Chinese and English through databases such as PubMed, Embase, Web of Science, Cochrane Library, SinoMed, CNKI, WanFang Database, and CQVIP from inception to 1 September 2022. Sata 16.0 software was used for analysis. Results: A total of 28 studies were included with a sample size of 1,433,971 and had a satisfactory quality score of ≥ 5. The prevalence among PLWHA in China were 30% for suicidal ideation (SI), 5% for suicide attempt (SA), 8% for suicide plan (SP), 7% for attempted suicide (AS), and 3‰ for completed suicide. High stigma (OR = 2.94, 95%CI: 1.90 − 4.57), depression (OR, 3.17; 95%CI, 2.20 − 4.57), anxiety (OR, 3.06; 95%CI, 2.23 − 4.20), low self-esteem (OR, 3.82, 95%CI, 2.22 − 6.57), high HIV related stress (OR, 2.53; 95%CI, 1.36 − 4.72), and unemployment (OR, 2.50; 95%CI, 1.51 − 4.15) are risk factors for SI; high social support (OR, 0.61; 95%CI, 0.44 − 0.84) and spouse infected with HIV (OR, 0.39; 95%CI, 0.21 − 0.74) are protective factors for SI; depression (OR, 1.62; 95%CI, 1.24 − 2.13), high aggression (OR, 4.66; 95%CI, 2.59 − 8.39), and more negative life events (OR, 2.51; 95%CI, 1.47 − 4.29) are risk factors for AS; high level of education (OR, 1.31; 95%CI, 1.21 − 1.43) is risk factor for CS. Conclusion: Figures indicate that approximately one-third of PLWHA had suicidal ideation, and three out of 1,000 completed suicide in China. Positive events are protective factors for self-injury and suicide among PLWHA, while negative events are risk factors. This suggests that psychosocial support and risk assessment should be integrated into the care of PLWHA. [ABSTRACT FROM AUTHOR]