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Primary Healthcare Providers

Yes, You CAN

How Does Suicidal Ideation Come About?
The hopelessness that patients might start to feel after being
diagnosed with HIV can be a result of one of two possible
emotional routes: feeling stigmatized by the society or being
alienated from their families, either of which may cause suicidal

It must be hard to lose a patient to suicide, especially : causes patients to fear discrimination from
knowing that they could have made it. Suicide has been an society for having the disease. Patients react by avoiding
increasing epidemic in recent years, and those who have interaction with society altogether.
been diagnosed as HIV-positive are not immune to it.
However, we have a way to decrease suicidal
ideation among such patients. The solution is to solve an
underlying problem first.

What is that Underlying Problem?

Positive HIV diagnosis can lead to other psychological
problems, such as . The column
. Because some patients dont want to disturb
diagram below (Figure 1) shows depression rates in a group of
their families by the news, they hide their diagnosis.
HIV patients in the United States at two different times after
diagnosis1. The results were measured by three different
scoring systems: BSH, BDI, and Pearsons Correlation (P. C.),
all of which show either persistent or increasing depression
rates between 72 hours and 6 weeks after diagnosis. It turned This type of secrecy can be thought of as an isolation from society
out that one of the major contributors to these rates is into the darkness of loneliness, which directly leads to thinking
The primary healthcare providers also play a crucial role in the
equation. Scientific evidence shows that the first 72 hours after
diagnosis are the golden hours of suicide prevention in HIV
positive patients1. Providing counselling within these first three
days after diagnosis proved its effectiveness to decrease suicidal
thinking in seropositive patients1. The discussion here should not
be understood as a trial to undermine the efforts of the primary
healthcare doctors. The intent is based on our fear that health-
systemic delays may inadvertently leave the patients alone with
their unguided and noisy thinking during that salient period of
time. As is well known, prevention is more certain than treatment.

Figure 1. Depression rates in HIV+ patients at two different

times measured by three scoring systems. Both BSH and P.C.
show an increase between the two time points
Yes, You CAN
What Can You Do as a Doctor?
Trying to guide the patients to talk about their thoughts of death
and about the disease by referring them to a specialized
counselling center within the suggested golden1 period seems
to be positively effective. One study shows that talking to patients
about the disease itself distances them from suicidal ideation2. In
this sheet, HIV is not the epidemic we are fighting; it is social
isolation. We hope to achieve two things regarding the patients:

Encourage them to speak their minds, and

Change their perspectives.

What Can We Do?

We have designed a website ( for
this purpose. In the SHARE YOUR OPINION page, the public can
post their encouraging, hopeful comments to the patients, and the
patients can share their experiences and thoughts. We are also
considering the possibility that some people might in fact post
discouraging comments. Therefore, and to ensure the safety of the
patients feelings, the comments function on the website is
designed to send a notification to the website directors when new
comments are posted. The comments are not published to the
world until the directors review them and permit publication.
Ultimately, the goal of the website is to eliminate the mirage of
social stigma and build trust in the minds of the patients that there
are people in the world that care about them, that support them,
that believe in them, and that they will never have to fight this
battle alone.