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Cited by 148Suicide and Self-Harm StudiesHIV/AIDS Research and InterventionsLGBTQ Health, Identity, and Policy

Suicidal thoughts and behaviour among South African adolescents living with HIV: Can social support buffer the impact of stigma?

Casale, Marisa, Boyes, Mark, Pantelic, Marija, Toska, Elona, Cluver, Lucie·2019·Journal of Affective Disorders
DOI 10.1016/j.jad.2018.10.102
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Abstract

Background Adolescents living with HIV represent a high-risk population for suicidal ideation and attempts, especially in low-income settings. Yet little is known about risk and protective factors for suicide in this population. Methods A moderated mediation model was employed to test for potential (a) effects of stigma on suicidal ideation and attempts, both direct and mediated through depression and (b) direct and stress-buffering effects of social support resources on depression and suicidal ideation and attempts, among 1053 HIV-positive 10-19-year-old adolescents from a resource-scarce health district in South Africa. The survey data was collected using full community sampling of 53 clinics and tracing to over 180 communities. Effects of two support resources were tested: perceived support availability from the adolescents' social network and structured clinic support groups. Stigma was measured using the ALHIV-SS scale, depression through the CDI short form and social support through items from the MOS-SS. Results Stigma was a risk factor for depression (B = 0.295; p Limitations The data used in this study was self-reported and cross-sectional. Conclusions Findings suggest that strengthening multiple social support resources for HIV-positive adolescents, through early clinic and community-based interventions, may protect them from experiencing poor mental health and suicidal tendencies.

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  • Casale et al. (2019) reported that higher perceived social support was weakly associated with less depression (r = -0.259, p < 0.001) among South African ALHIV.

    “Another paper using the same sample of South African ALHIV reported that higher perceived social support was weakly associated with less depression ( r = -0.259, p &lt; 0.001) (Casale et al., 2019).”

    From Resilience resources for mental health among people living with HIV: a mixed-method systematic review (2024) · cites this paper as Casale et al., 2019

  • The review infers that differences between Boyes et al. and Casale et al. findings on support group attendance are probably attributable to variations in methodological approach, such as Casale et al. including more explanatory factors which likely attenuated associations.

    “The differences in the observed findings are probably attributable to variations in methodological approach, for example, Casale et al., included a greater number of potential explanatory factors in their correlation and regression models, which likely acted to attenuate associations.”

    From Resilience resources for mental health among people living with HIV: a mixed-method systematic review (2024) · cites this paper as Casale et al., 2019

  • Casale et al. (2019) reported that participating in an HIV support group was not associated with depression (β = -0.113, p > 0.05) and suicidal thoughts (β = -0.017, p > 0.05) among ALHIV.

    “In contrast, using the same sample, Casale et al. reported that participating in an HIV support group was not associated with depression ( β = -0.113, p &gt; 0.05) and suicidal thoughts ( β = -0.017, p &gt; 0.05) among ALHIV (Casale et al., 2019).”

    From Resilience resources for mental health among people living with HIV: a mixed-method systematic review (2024) · cites this paper as Casale et al., 2019

  • Three studies included adolescents (10-19 age range).

    “Three studies (Boyes et al., 2019; Casale et al., 2019; Woollett et al., 2016) included adolescents (10-19 age range).”

    From Resilience resources for mental health among people living with HIV: a mixed-method systematic review (2024) · cites this paper as Casale et al., 2019

  • Casale et al. (2019) found evidence of an interaction (β = -0.23, p < 0.01; not shown) that may have reduced the strength of association between support group attendance and depression.

    “There was evidence of an interaction ( β = -0.23, p &lt; 0.01; not shown) which may have reduced the strength of association between support group attendance and depression.”

    From Resilience resources for mental health among people living with HIV: a mixed-method systematic review (2024) · cites this paper as Casale et al., 2019

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Authors
Casale, M., Boyes, M., Pantelic, M., Toska, E., & Cluver, L.
Affiliations
  • University of Oxford (GB)
  • Curtin University (AU)
  • International HIV/AIDS Alliance (GB)
  • University of Cape Town (ZA)
Corresponding author
Casale, Marisa
ORCID
Venue
Journal of Affective Disorders
Publisher
Elsevier BV
Published
2019-02
Volume
245
Pages
82-90
ISSN
0165-0327 (ISSN-L)
DOI
10.1016/j.jad.2018.10.102
OpenAlex
W2896170377
Cited by
148
References
69
Citations by year
2026: 16 · 2025: 15 · 2024: 16 · 2023: 20 · 2022: 22 · 2021: 23 · 2020: 31 · 2019: 5
FWCI
17.30
Type
journal article
Language
en
Open access
closed
Licence
Locations
  • Journal of Affective Disorders (publishedVersion)
  • PubMed (publishedVersion)
  • eSpace (Curtin University) (submittedVersion)
  • UWC Research Repository (University of the Western Cape) (submittedVersion)
Funders
  • Nuffield Foundation (CPF/41513)
  • International AIDS Society (155-Hod)
  • Janssen Pharmaceutica
  • Claude Leon Foundation (F08 559/C)
  • Oak Foundation (R46194/AA001)
  • UNFPA
  • UNICEF
  • John Fell Fund (103/757, 161/033)
  • Oxford University
  • European Research Council (FP7/2007-2013)
  • Philip Leverhulme (PLP-2014-095)
  • University of Oxford (IAA-MT13-003, K1311-KEA-004, 1602-KEA-189)
Topics
  • Social Sciences › Psychology › Clinical Psychology › Suicide and Self-Harm Studies
  • Health Sciences › Medicine › Infectious Diseases › HIV/AIDS Research and Interventions
  • Social Sciences › Psychology › Social Psychology › LGBTQ Health, Identity, and Policy
Keywords
suicidal ideation, suicide attempts, adolescents living with HIV, HIV stigma, social support, depression, stress buffering, support groups, mental health, South Africa
MeSH terms
Adolescent, Adolescent Behavior, Adult, Child, Cross-Sectional Studies, Female, Humans, Male, Surveys and Questionnaires, Risk Factors, Social Support, South Africa, Suicide, HIV Infections, Black People, Young Adult, Social Stigma, Self Report, Suicidal Ideation

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