Suicidal risk in people living with HIV in Ukraine: The role of depression, anxiety, and psychosocial factors

Abstract

Background. Suicidality remains a critical public health concern among People Living With Human immunodeficiency virus (PLWH). Psychological distress, including depression and anxiety, has been identified as a major predictor, but data from Eastern Europe remain limited.

Aim. To assess the relationship between depression, state anxiety, and suicidal risk among PLWH.

Materials and Methods. A cross-sectional study included 132 adult patients with confirmed human immunodeficiency virus infection who attended Sumy Regional Clinical Medical Center for Socially Dangerous Diseases. Exclusion criteria were pregnancy, active substance use disorder, current opioid substitution therapy, severe somatic condition, or inability to provide informed consent. Participants completed the Luban–Plozza Suicide Risk Scale, Beck Depression Inventory, State-Trait Anxiety Inventory – State Subscale, and Symptom Checklist-90-Revised. Demographic and clinical data, including CD4 count and clinical stage, were collected. The study was performed within the approved PhD dissertation topic "Anxiety-depressive disorders in PLWH: clinical-psychopathological features, psychosocial determinants, and therapeutic approaches". Statistical analysis was performed in R software 2025.05.1 (R Foundation for Statistical Computing, Austria). Normality was assessed using the Shapiro–Wilk test; Spearman correlation, non-parametric group comparisons, and multiple linear regression were used. Regression coefficients are reported as unstandardized coefficients (B).

Research Ethics. The study was approved by the Bioethics Committee of Sumy State University. All participants provided informed consent.

Results. The mean Luban–Plozza score was 3.02, standard deviation – 2.4 points, with a median of 2 points and an observed range of [0÷10] points out of 16 possible points. Elevated suicidal risk was defined by the 75^th percentile threshold, ≥4 points. Depressive symptoms (B=0.098, p<0.001) and state anxiety (B=0.054, p=0.002) were the only statistically significant independent predictors. The model explained 42.4% of the variance. Age, sex, CD4 count, clinical stage, socioeconomic status, marital status, employment, number of children, and alcohol use were not significant predictors.

Conclusions. Depression and state anxiety are key determinants of suicidal risk in PLWH. Mental health screening should be integrated into HIV care regardless of demographic or clinical profile. Early identification and intervention may reduce suicidality and improve HIV-related outcomes.

Keywords: psychiatry, PLWH, suicidality, psychosocial determinants, Luban–Plozza scale, mental health.