Evidence map›Paper›PMID 41661875›Full record

ArticlePLOS mental health2025

"Everyone is fighting their own battles": A qualitative study to explore the context of suicidal ideation among people with HIV (PWH) in Kilimanjaro, Tanzania.

Ismail Amiri, Brandon A Knettel, Clotilda S Tarimo, Kearsley A Stewart, Aunchalee E L Palmquist, Judith M Mwobobia, Victor Katiti, Elizabeth Knippler, Linda Minja, Kim Madundo and 6 more

Abstract read
In one paragraph

Article in PLOS mental health, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed.

  1. Trial
  2. Article
  3. Article
  4. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

16 authors.

Ismail AmiriDuke Global Health Institute, Duke University, Durham, North Carolina, United States of America.ORCID https://orcid.org/0000-0002-7533-7578
Brandon A KnettelDuke Global Health Institute, Duke University, Durham, North Carolina, United States of America.ORCID https://orcid.org/0000-0003-2986-1579
Clotilda S TarimoKilimanjaro Christian Medical Centre, Moshi, Tanzania.
Kearsley A StewartDuke Global Health Institute, Duke University, Durham, North Carolina, United States of America.ORCID https://orcid.org/0000-0002-9624-9956
Aunchalee E L PalmquistDuke Global Health Institute, Duke University, Durham, North Carolina, United States of America.ORCID https://orcid.org/0000-0002-0848-6952
Judith M MwobobiaBrown School, Washington University in St. Louis, St. Louis, Missouri, United States of America.
Victor KatitiKilimanjaro Christian Medical Centre, Moshi, Tanzania.
Elizabeth KnipplerDuke University School of Nursing, Durham, North Carolina, United States of America.
Linda MinjaDuke Center for AIDS Research, Duke University, Durham, North Carolina, United States of America.
Kim MadundoKilimanjaro Christian Medical Centre, Moshi, Tanzania.ORCID https://orcid.org/0000-0003-0927-1678
Elizabeth F MsokaKilimanjaro Christian Medical Centre, Moshi, Tanzania.ORCID https://orcid.org/0000-0002-2352-3520
Alyssa MartinezDuke Global Health Institute, Duke University, Durham, North Carolina, United States of America.ORCID https://orcid.org/0000-0003-4493-0472
Judith BosheKilimanjaro Christian Medical Centre, Moshi, Tanzania.
Michael V RelfDuke Global Health Institute, Duke University, Durham, North Carolina, United States of America.
Blandina T MmbagaDuke Global Health Institute, Duke University, Durham, North Carolina, United States of America.ORCID https://orcid.org/0000-0002-5550-1916
David B GoldstonDepartment of Psychiatry and Behavioral Sciences, Duke University, Durham, North Carolina, United States of America.

Funding

Social and Behavioral Sciences CoreP30AI064518 · NIAID · DUKE UNIVERSITY · PI Nwora Lance Okeke · 2005 to 2026
$50.5M
Sociobehavioral Sciences Research to Improve Care for HIV Infection in TanzaniaD43TW009595 · FIC · KILIMANJARO CHRISTIAN MEDICAL CENTRE · PI Blandina Theophil Mmbaga · 2013 to 2026
$4.2M
Telehealth to Reduce Suicidality and lmprove HIV Care Engagement in TanzaniaK08MH124459 · NIMH · DUKE UNIVERSITY · PI KNETTEL, BRANDON A · 2021 to 2024
$694k
FIC NIH HHS D43 TW009595NIAID NIH HHS P30 AI064518NIMH NIH HHS K08 MH124459
6 · The paper itself

Abstract

Tanzania faces significant HIV-related challenges with 1.4 million people currently living with HIV, 33,000 new infections, and 22,000 AIDS-related deaths annually. Suicide is a leading cause of death among People with HIV (PWH), with one-quarter of all deaths by suicide in Tanzania occurring among PWH. Despite this challenge, mental health resources are scarce, with only 55 psychologists and psychiatrists in the country, and clinic staff in HIV care lack adequate mental health training. This qualitative study explores the experiences of PWH who have recently had suicidal thoughts. The aim is to create targeted mental health interventions in Kilimanjaro. Participants were screened for suicidal ideation during routine care at two HIV clinics, with semi-structured qualitative interviews conducted thereafter. Data were analyzed using thematic analysis aided by NVivo 12 software. PWH experiencing suicidal ideation encounter multiple stressors related to their HIV diagnosis, societal stigma, financial stress, and broader social challenges. Suicide is sometimes viewed as an escape from these difficulties. Coping mechanisms include seeking assistance from family and religious leaders, but social support is hindered by fear of stigma. While participants expressed openness to counseling, treatment options were extremely limited. Suicide risk among PWH is influenced by stressors related to HIV, such as socioeconomic challenges, HIV stigma, low social support, and accompanying psychological distress. There is a clear need for improved mental health care options customized to the needs of PWH in Tanzania and other low-resource settings.

Identifiers

PMID41661875
PMCPMC12798187

What OpenQuestion holds

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.