Depression, Suicidality, and HIV

To the Editor: Studies to evaluate the impact of the HIV infection with regard to depression and suicidality have shown conflicting results. One study noted a dramatic and sustained rise in depressive symptoms as AIDS develops (1). However, a large study in HIV-seropositive military applicants found that infection with HIV does not in and of itself appear to increase the risk of suicide (2). We report an unusual, tragic case of depression, suicidal acquisition of HIV, and premature death.

There have been only anecdotal reports of similar cases. A homosexual individual with suicidal thoughts who repeatedly sought sexual partners infected with HIV succeeded in becoming infected (3). A 41-year-old woman from France inoculated herself with blood obtained from a friend terminally ill with AIDS, and prophylactic zidovudine failed to prevent infection (4). A 27-year-old man, in a suicide attempt, injected himself with blood from an individual infected with HIV and human coronavirus, and seroconversion occurred with both of the viruses (5). These cases indicate that some suicidal individuals are at risk for self-infection with HIV. The emotional, physical, and economic burden imposed by HIV and related infections on the depressed individual are enormous. Unless the perception of HIV infection as a fatal disease can change, more cases of suicidal acquisition of HIV are to be expected. Such occurrences are of epidemiological and economic significance and demand further insight into the problem.