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Reported Suicide Attempts among Adolescents in Uganda: Differences by HIV Status

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Abstract

Suicide remains a global public health concern and is a leading cause of death among adolescents. Adolescents with perinatally-acquired HIV (PHIV) are particularly vulnerable to suicide and other challenges, including discrimination, stigma, educational difficulties, risk-taking behaviors, and medical complications. In Uganda, adolescents with PHIV experience a high burden of mental health problems, but there is scant information regarding suicide attempts. This study examined lifetime suicide attempts, depressive symptoms, and adverse experiences among adolescents with PHIV and demographically matched HIV-negative adolescents. One hundred Ugandan adolescents (12–20 years old), 50 with and 50 without PHIV, completed the Adverse Childhood Experiences (ACEs) questionnaire, Patient Health Questionnaire-A (PHQ-A), and the Adolescent Life Events Questionnaire (ALEQ), which included additional questions about suicide attempts. Independent t-test and chi-square analyses were used to compare scores between the two HIV status groups. There were no significant differences in sex across the HIV groups. The mean total scores of the full sample were ACEs M = 2.92 (SD = 2.49), ALEQ M = 10.61 (SD = 9.08) and PHQ-A M = 2.25 (SD = 3.55). The PHIV group had significantly higher PHQ-A (p < .001), ALEQ (p < .01), and ACEs (p < .001) scores than the HIV-negative group. Among adolescents with PHIV, 14% reported at least one previous suicide attempt, while none of the HIV-negative adolescents reported any attempt (X2 = 8.20, p = .02). Despite overall low depression scores, the PHIV group had significantly more depressive symptoms and were more likely to have suffered from psychosocial stressors.

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Data Availability

De-identified study data is available on request.

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Code available on request.

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Acknowledgements

The authors would like to thank the patients and their parents who participated in this research.

Funding

This work was supported by the Eunice Kennedy Shriver National Institute of Child Health [K23HD088295 to SDF], by Fogarty R21-TW011683 to RNR and P30-MH43520.

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Authors and Affiliations

  1. Butabika National Referral Mental Hospital, Kampala, Uganda

    Angel Nanteza

  2. Department of Psychiatry, Makerere University College of Health Sciences, Kampala, Uganda

    Joy Gumikiriza-Onoria

  3. New York State Psychiatric Institute, Columbia University, New York, USA

    Anthony F. Santoro, Christopher M. Ferraris, Daphne Tsapalas, Courtney Kirsch, Nana Asiedu, Mei Tan, Jun Liu, Curtis Dolezal & Reuben N. Robbins

  4. Joint Clinical Research Center, Kampala, Uganda

    Christine Karungi & Victor Musiime

  5. Graduate School of Social Service, Fordham University, New York, NY, USA

    Mina Nguyen

  6. Department of Pediatrics and Child Health, College of Health Sciences, Makerere University, Kampala, Uganda

    Victor Musiime

  7. Northwestern Feinberg School of Medicine, Chicago, IL, USA

    Sahera Dirajlal-Fargo

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Contributions

RNR conceptualized and designed the study. Data collection was performed by AN, JGO, CK. Data analysis was performed by JL. Interpretation of the analyses was carried out with the support of all co-authors. The article was drafted by AN and revisions and final approval by all co-authors. All authors contributed to the article and approved the submitted version.

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Correspondence to Angel Nanteza.

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Ethical approval was obtained from the Ugandan National Council of Science and Technology, the JCRC Research Ethics Committee in Uganda, New York State Psychiatric Institute IRB, and University Hospitals Cleveland Medical Center IRB. Caregivers gave written informed consent for their children to be enrolled.

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Nanteza, A., Gumikiriza-Onoria, J., Santoro, A.F. et al. Reported Suicide Attempts among Adolescents in Uganda: Differences by HIV Status. AIDS Behav 29, 1004–1010 (2025). https://doi.org/10.1007/s10461-024-04581-y

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