High rates of suicide have been reported among people living with HIV, but there is little research that looks specifically at suicide among gay and bisexual men who are HIV positive. Existing studies only look at trends and do not explore why suicide is higher in this community, and more importantly, what can be done to prevent it.
These gaps in knowledge were the motivation behind our investigation into the issue of suicide among gay and bisexual men living with HIV. We used data from Sex Now, a national periodic survey led by the Community-Based Research Centre for Gay Men’s Health. Data from the latest survey, conducted between November 2014 and April 2015, were used for this analysis.
673 HIV-positive gay and bisexual men completed the 2014/15 Sex Now survey. Among these respondents, one in five said they had contemplated suicide in the last year. One in 20 reported a suicide attempt in the same time period. The rate of suicide attempts in the last 12 months was 1.5 times higher among gay and bisexual men living with HIV compared to HIV-negative men, and more than 12 times higher than the general population of Canadian men.
We hypothesized that HIV stigma may be a significant contributing factor to this elevated risk of suicide. Researchers have found that HIV stigma causes negative health outcomes among people living with HIV, including depression, lower social support, and lower levels of adherence to HIV medications. However, the relationship between HIV stigma and suicide has not yet received the same level of attention from the scientific community.
The latest Sex Now survey asked HIV-positive men about their experiences of HIV stigma. The results indicated that experiences of HIV stigma are common among gay and bisexual men living with HIV; in the last year, 57% reported being socially excluded because of their HIV status, 22% were rejected as a sexual partner, 17% were called names or verbally assaulted because they were HIV positive, and 3% were physically assaulted (Table 1).
Table 1. Individual effect of HIV stigma on recent suicide in the last 12 months
HIV stigma and suicide
The level of stigma also increased the risk of suicide ideation and attempts, particularly for those who experienced multiple forms of stigma (Figure 1). Among those who did not report any of the HIV stigma types we measured, only 2% reported a suicide attempt in the previous year. Of those who reported one type of HIV stigma, 5% reported a suicide attempt in the previous year. Of those who reported two or three forms of stigma, 7% and 9% respectively reported suicide attempts. And 40% of those who reported experiencing all four forms of stigma reported a recent suicide attempt.
Figure 1. Cumulative effect of HIV stigma on suicide attempts in the last 12 months
Implications for practice
These results were recently published in AIDS Care to draw attention to this issue and initiate a conversation about targeted prevention interventions for gay and bisexual men living with HIV.
Suicide is preventable. But to find solutions, we need to break the silence around HIV in the gay and bisexual communities. We also need to increase our efforts around de-stigmatizing HIV and mental illness.
If you or someone you know might be at risk of suicide, there is help. Please call the Crisis Center for support: 1-8000-suicide or visit crisiscentrechat.ca to chat with someone.
For more information
To read the full research report, visit: AIDS CARE http://www.tandfonline.com/doi/abs/10.1080/09540121.2017.1290762?journalCode=caic20
- Logie, C., & Gadalla, T. M. (2009). Meta-analysis of health and demographic correlates of stigma towards people living with HIV. AIDS Care, 21(6), 742–753. http://doi.org/10.1080/09540120802511877
- Public Health Agency of Canada. (2011). The human face of mental health and mental illness in Canada 2006. Retrieved from http://www.phac-aspc.gc.ca/publicat/human-humain06/11-eng.php