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Background: The increasing access to highly effective antiretroviral therapy for people living with HIV/AIDS in sub-Saharan Africa has delayed HIV disease progression and prolonged survival bringing to attention their psychological adjustment and wellbeing.One of the causes of psychiatric morbidity in HIV/AIDS is suicidality.Objective: To examines the prevalence and risk factors of suicidality in HIV/AIDS in semi-urban Uganda.Methods: A cross-sectional study was undertaken among 618 respondents attending two HIV clinics in semi-urban Uganda.A structured questionnaire was used to collect data on demographic, social, psychological and clinical factors.Suicidality was assessed using criteria in the M.I.N.I.neuropsychiatric interview schedule (Sheehan et al.1998).Both bivariate analysis using the Chi square statistic and multivariable logistic regression were used to assess the correlates of suicidality using the statistical package SPSS.Results: Prevalence of moderate to high risk suicidality was 48 (7.8%) while attempted suicide in the past year was 6 (1.0%).Factors significantly associated with suicidality at bivariate analysis were: female gender, food insecurity, poor psychosocial function, high risk sexual behaviour, a negative coping style, negative life events, high stress scores associated with negative life events, a previous psychiatric history, a current diagnosis of major depressive disorder (excluding the suicidality items) and post traumatic stress disorder.Factors independently significantly associated with suicidality at multivariate analysis were: a previous psychiatric history, a current diagnosis of major depressive disorder (excluding the suicidality items) and post traumatic stress disorder.Conclusion: Psychiatric comorbidity was the strongest independent determinant of suicidality in HIV/AIDS in this socio-cultural environment.Interventions to address suicidality in HIV/AIDS in this environment should include efforts at increased screening and treatment of psychiatric disorder in HIV/AIDS.