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Article
July 1, 1988

The Risk of Suicide in Persons With AIDS-Reply

Author Affiliations

Cornell University Medical College New York
New York
Office of Chief Medical Examiner New York

Cornell University Medical College New York
New York
Office of Chief Medical Examiner New York

JAMA. 1988;260(1):30. doi:10.1001/jama.1988.03410010037017
Abstract

In Reply.—  Dr Beltangady observes correctly that the AIDS-related suicide rate would be lower if it were calculated without considering time at risk. However, we believe our method of reporting rates on a population-time basis is an appropriate one. When considering AIDS, it is important to correct for survival time, since this varies among subgroups of patients with AIDS and may change as new treatment modalities become available.We do believe, contrary to Dr Beltangady's comment, that the total number of AIDS-related suicides is definitely underestimated. Most AIDS deaths are certified by primary care physicians, not coroners, and are presumed to be the natural outcome of a fatal illness. Thus, suicides—especially those due to medication overdoses—may be missed inadvertently because of certification bias. In addition, the difficulty of determining suicidal intent in drug-using populations is well known.In support of our suggestion that an appropriate comparison group for assessment of

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