The Trend in Suicide Risk Among People with HIV Before, During, and After the COVID-19 Pandemic Lockdown

Suicide Risk (SR) and the COVID-19 pandemic affected People with HIV (PWH) disproportionately in comparison with the general population, but little information on SR during and after the COVID-19 lockdown on the Latino PWH has been described, therefore, this study aimed to describe SR in PWH attended the HIV clinic before (2018-2019), during (2020), and after (2021-2022) the COVID-19 lockdown, the trend of SR, and the factors associated. Three standardized questions from the "Columbia-Suicide Severity Rating Scale" (C-SSRS) were routinely applied as screening for suicide risk to all PWH attending their clinical visits during 2018-2022. We estimated suicidality risk and rate. We compared sociodemographic characteristics in those with and without SR. We evaluated the potential association of SR with the calendar year before, during, and after the COVID-19 lockdown using a mixed-effects logistic regression. A total of 2330 patients were seen during the study period; 2157 (93%) were evaluated for suicidality at least once, of those, 75 (3.5%) had SR. Those with SR compared with non-SR were more frequently women (20% vs 10%) and with a heterosexual HIV transmission route (29% vs 23%). SR rates per 1000 patients-day among those evaluated were 0.03 in 2018, 0.25 in 2019, 3.16 in 2020, 7.0 in 2021 and 11.98 in 2022. Throughout the model, independently of covariables, a significant increase in the OR of SR was observed in these years compared to 2018: 1.07 in 2019; 2.74 in 2021; and 4.82 in 2022, except in 2020, OR = 0.18.