Prevalence and associated factors of suicidal ideation, plans, and attempts among LGBTQ+ individuals: A cross-sectional study in Vietnam

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BACKGROUND: Suicidality is a critical public health concern among LGBTQ+ youth, yet evidence from Vietnam remains limited. This study estimated the prevalence of suicidal ideation, plans, and attempts and examined associated sociodemographic and psychological factors among Vietnamese LGBTQ+ youth. METHODS: We conducted a community-based, online cross-sectional survey from February to April 2025. Participants included 384 LGBTQ+ individuals aged 18-24 years residing in Vietnam. Participants were recruited through the LGBTQ+ -led or LGBTQ+ -supportive social media and community networks. Suicidality was assessed alongside symptoms of depression, anxiety, and stress using the Depression Anxiety Stress Scales (DASS-21). Monthly income was self-reported and categorized into USD bands. Multivariable logistic regression models were employed to identify factors associated with lifetime suicidal outcomes. RESULTS: The lifetime prevalence of suicidal ideation, plans, and attempts was 56.5%, 32.1%, and 16.9%, respectively. Recent (past 12 months) prevalence was 5.5%, 3.6%, and 3.1%. In multivariable analyses, stress [AOR = 4.52 (95% CI: 2.35-8.72)] and anxiety [AOR = 2.12 (95% CI: 1.03-4.34)] were associated with higher odds of suicidal ideation and plans. Anxiety emerged as the sole independent predictor of suicide attempts [AOR = 4.30 (95% CI: 1.28-14.41)]. Conversely, higher income (≥USD 386/month) and rural residence were associated with lower odds of suicidal ideation. CONCLUSIONS: Suicidality is highly prevalent among this accessible, predominantly urban, and connected subpopulation of LGBTQ+ youth in Vietnam. Anxiety and stress are the most robust proximal correlates of suicidal behaviors. Suicide prevention strategies for this population must incorporate routine screening for anxiety and stress, deliver LGBTQ + -affirming care, and address underlying economic vulnerabilities.

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