Marijuana Use Among Young Black Men Who Have Sex With Men and the HIV Care Continuum: Findings From the uConnect Cohort

Abstract

Background Young Black men who have sex with men (YBMSM) are at highest risk for HIV seroconversion in the United States. Successful movement through the HIV care continuum is an important intervention for limiting onwards HIV transmission. Objective Little data exists on how substances most commonly used by YBMSM, such as marijuana, are related to the HIV continuum, which represents the primary aim of this study. Methods A cohort of YBMSM (N=618) was generated through respondent-driven sampling. Frequency of marijuana use and marijuana use as a sex drug were assessed across the HIV care continuum using weighted logistic regression models. Results Study participants reported more intermittent marijuana use (n=254, 56.2%) compared to heavy use (n=198, 43.8%). Our sample contained 212 (34.3%) HIV seropositive participants of which 52 (24.5%) were unaware of their HIV positive status. Study participants who were heavy marijuana users were more likely to be unaware of their HIV seropositive status (AOR: 4.18; 95% CI 1.26, 13.89). All other stages in the care continuum demonstrated no significant differences between those who use marijuana intermittently or heavily or as a sex-drug and non-users. Conclusions Young Black men who have sex with men who used marijuana heavily were more likely to be HIV-positive unaware than those who never used marijuana. Findings were inconclusive regarding the relationships between marijuana use and other HIV care continuum metrics. However, knowledge of ones' HIV status is a critical requirement for engaging in care and may have implications for onwards HIV transmission.

Determinants of HIV Phylogenetic Clustering in Chicago Among Young Black Men Who Have Sex With Men From the uConnect Cohort

“…Any marijuana use has previously been associated with participation in HIV risk behaviors including both condomless sex and group sex 13 while heavy marijuana use has been associated with being HIV positive and unaware of one’s status. 15 Our findings support this past research and suggest that engaging heavy marijuana users in HIV prevention efforts may reduce the overall size of transmission clusters and may serve to disrupt forward transmission of HIV through networks of YBMSM.…”

“…13 Briefly, uConnect is a longitudinal population-based cohort study 14,15 which was designed to assess factors associated with HIV risk and transmission among a sample of YBMSM. uConnect participants resided mainly in South Chicago and the adjacent southern suburbs, which represents the largest contiguous Black community area in the United States.…”

At the intersection of criminal justice involvement and sexual orientation: Dynamic networks and health among a population-based sample of young Black men who have sex with men

“…Despite its many assets, the region is burdened by lack of basic resources and structural factors, including highest incarceration rates in the city, that contribute to a number of health problems, including a high HIV prevalence. We use data from the uConnect study, a longitudinal population-based cohort of YBMSM on the south side of Chicago that examines how social and sexual networks affect men’s behaviors as well as physical and mental health related to risk of sexually transmitted infections (STIs) including HIV (Khanna et al, 2016; Morgan, 2016). …”

“…Recruitment for the uConnect study has been described previously (Khanna et al, 2016; Morgan, 2016; J. A. Schneider et al, 2013).…”

“…Respondents were asked if they ever used marijuana and frequency of use from several times a day to less than once a year. On the basis of responses to these questions, we coded a 3-level measure of Never, Moderate (less than daily) and Heavy use (once a day or greater) (Morgan, 2016). Depression, anxiety and distress symptoms were analyzed using the Brief Symptom Inventory 18-question survey (BSI-18), a self-report measure of psychological symptoms over the previous week (Derogatis, 2001).…”