Marijuana use and HIV treatment outcomes among PWH receiving care at an urban HIV clinic

Abstract

Background While marijuana use is prevalent among persons with HIV (PWH), few studies have examined the relationship between marijuana use and HIV treatment outcomes independent of alcohol and other drug use. Methods We conducted a prospective cohort study to examine the relationships between frequency of marijuana use and antiretroviral therapy (ART) adherence and viral suppression in patients enrolled in the Johns Hopkins HIV Clinical Cohort between September 2013 through November 2015 (N=1377). We categorized marijuana use as no use, none in the last 3 months, monthly use or less, weekly/daily. Our outcomes of interest were use of ART, ≥90 ART adherence, and viral suppression (HIV1-RNA <200 copies). We conducted multivariable analyses to examine associations between the frequency of marijuana use and our treatment outcomes, using generalized estimating equations to account for repeated measures. Other independent variables of interest included alcohol use, other drug use, and depressive symptoms. Analyses were adjusted for age, race, sex and HIV acquisition risk factor. Results In multivariable analyses we found no statistically significant association between frequency of marijuana use and our treatment outcomes. Alcohol use, other drug use and depressive symptoms were associated with lower odds of ART adherence and viral suppression. Conclusions In this sample of PWH in care, frequency of marijuana use independent of other substance use does not appear to be associated with negative HIV treatment outcomes. Our results indicate that unlike alcohol, other substances and depression, marijuana use may not be a barrier to the effective treatment of HIV.

Improving Medication Adherence Among Drug-Using HIV-Infected Formerly Incarcerated Individuals: A Pilot Test of Two Interventions

“…Recent metaanalyses have indicated that single-session interventions are crucial for reducing HIV transmission and ideal for implementation in resource-deprived environments (Diallo et al, 2010;Eaton et al, 2012;Sagherian et al, 2016); they have also shown promising results in improving adherence among individuals with adherence problems (Safren et al, 2001). Similar to previous research on ART adherence, our findings suggest that marijuana usage does not prevent HIV-infected individuals from adhering to their ART regimen (Mimiaga et al, 2013;Sinha et al, 2017). Instead, recent marijuana use was associated with VL reduction over the previous 3 months, which may indicate that participants were using marijuana for therapeutic or medicinal purposes, which has been observed in previous studies on drug use among HIV-infected individuals (de Jong et al, 2005;D'Souza et al, 2012).…”

Health related behaviors among HIV-infected people who are successfully linked to care: an institutional-based cross-sectional study

“…"g" is gram. "ml" is milliliter earlier research done in other countries, which showed approximately 25% used alcohol in Africa and 21.8% in the United States in previous month [16,17]. Evidence has shown that the health outcomes are worse in patients who often drink alcohol, including a higher incidence of psychosocial problems and lower treatment adherence levels [18][19][20][21][22].…”

Determining the Roles that Club Drugs, Marijuana, and Heavy Drinking Play in PrEP Medication Adherence Among Gay and Bisexual Men: Implications for Treatment and Research

“…57 In contrast to alcohol and club drug use, recent evidence suggests no link between marijuana use and HIV medication non-adherence. 58,59 Nonetheless, further study is needed with PrEP users who use marijuana because of the varying contextual situations in which anti-retrovirals are used (i.e., for sustained health among people living with HIV compared to HIV prevention among PrEP users), which could result in differential adherence patterns.…”