Risk of suicide attempts among patients with sexually transmitted infections: A Nationwide population-based matched...

While human immunodeficiency virus (HIV) is generally considered a risk factor for suicide, longitudinal evidence regarding suicide risk across a broader spectrum of sexually transmitted infections (STIs) remains limited. This study investigated the risk of subsequent suicide attempts following diagnoses of various STIs.

Using the Taiwan National Health Insurance Research Database (NHIRD), we conducted a nationwide longitudinal cohort study spanning 1998 to 2013. Patients diagnosed with HIV, genital warts, gonorrhea, syphilis, chlamydia, or trichomoniasis were enrolled (n = 71,666) and matched 1:4 with non-STI controls (n = 286,664) by age, sex, income, urbanization, and psychiatric comorbidities. The primary outcome was suicide attempts, analyzed using Cox proportional hazard models.

Patients with STIs exhibited a significantly elevated risk of suicide attempts compared to matched controls (hazard ratio [HR]: 5.64, 95% confidence interval [CI]: 5.30-6.00). Elevated risks were observed across all subgroups, with syphilis (HR: 8.08, 95% CI: 6.90-9.46) and trichomoniasis (HR: 6.77, 95% CI: 6.22-7.37) demonstrating the strongest associations. The mean interval from enrollment to suicide attempt was notably shorter in the STI group compared to controls (4.60 vs 7.36 years). Sex-stratified analyses revealed distinct risk profiles, including markedly high risks in men with HIV and trichomoniasis.

Patients with STIs are at a significantly increased risk of suicide attempts, often occurring within a shorter timeframe post-diagnosis. These findings highlight the critical need for integrating proactive suicide risk assessment and psychosocial support into routine STI care to mitigate these adverse outcomes.