Syndemic vulnerability for suicidal ideations among youth with and without HIV in India: a latent class approach

Suicide is a vital public health challenge among adolescents in low-middle-income countries. HIV might be clustering health conditions among adolescents in India, contributing to suicidal ideation (SI). We used data from a cross-sectional and conveniently sampled study among adolescents (15-19 years) at a tertiary care government hospital conducted between August 2018 and June 2020. Latent class analysis was used to identify syndemic vulnerability for SI according to differential clustering of mental health conditions, malnutrition, food insecurity, and parental loss. A total of 195 adolescents were included in the analysis. SI was reported by 20.51% of the adolescents. Three latent classes of syndemic vulnerability were identified: 1. Low syndemic vulnerability (Class I) 2. Multiple syndemic vulnerability (Class II) 3. Mental health syndemic vulnerability (Class III). HIV status was associated with a five-fold increase in multiple vulnerabilities. Class II and Class III were associated with a nine-fold and eight-fold increase in SI. Mental health syndemic vulnerability was seen to moderate the relationship between HIV status and SI. Findings indicate that syndemic-informed interventions should target mental health screening, treatment, and nutritional intervention at the individual level, food security, and support for parental loss at the societal level among adolescents, including adolescents with HIV.