Mannes Zachary L, Burrell Larry E, Ferguson Erin G, Zhou Zhi, Lu Huiyin, Somboonwit Charurut, Cook Robert L, Ennis Nicole
Department of Clinical and Health Psychology, College of Public Health and Health Professions, University of Florida, Gainesville, FL, USA,
Department of Epidemiology, College of Public Health and Health Professions.
Patient Prefer Adherence. 2018 Jul 27;12:1363-1372. doi: 10.2147/PPA.S167826. eCollection 2018.
Marijuana use is common among people living with HIV (PLWH), but its association with antiretroviral therapy (ART) adherence is unclear. This study examined the association between reason for marijuana use and ART adherence in a sample of adults living with HIV.
Participants (N=703) recruited from seven community health centers in Florida completed a 45-minute questionnaire assessing demographics, symptoms of anxiety and depression, ART adherence, and substance use, including reasons for marijuana use. ART adherence was defined as the proportion of days in the last 30 days participants did not miss any medication and dichotomized as optimal (≥95%) and suboptimal (<95%). Multivariate logistic regression analysis assessed the association between therapeutic marijuana use to manage HIV symptoms (ie, improve appetite/gain weight, induce sleep, relieve nausea/vomiting, relieve pain, relieve anxiety/depression/stress) versus recreational marijuana use and ART adherence.
Approximately one third (33.2%) of the participants reported using marijuana in the past 3 months. Of marijuana users, 21.8% reported using marijuana only for therapeutic purposes to manage HIV-associated medical symptoms, while 78.2% reported recreational use. After controlling for covariates, therapeutic use of marijuana was not associated with ART adherence (AOR =1.19, 95% CI =0.60-2.38, =0.602) while recreational marijuana users showed significantly greater odds of suboptimal ART adherence compared to nonusers (AOR =1.80, 95% CI =1.18-2.72, =0.005).
Our results suggest differences in ART adherence between individuals who report recreational versus therapeutic marijuana use. Continued research examining the health implications of marijuana use among adults living with HIV is important as legalization of recreational and medical marijuana proliferates in the United States.
大麻使用在艾滋病毒感染者（PLWH）中很常见，但其与抗逆转录病毒疗法（ART）依从性的关联尚不清楚。本研究在一组成年艾滋病毒感染者样本中考察了大麻使用原因与ART依从性之间的关联。
从佛罗里达州的七个社区卫生中心招募的参与者（N = 703）完成了一份45分钟的问卷，评估人口统计学、焦虑和抑郁症状、ART依从性以及物质使用情况，包括大麻使用原因。ART依从性定义为参与者在过去30天内未漏服任何药物的天数比例，并分为最佳（≥95%）和次优（<95%）两类。多变量逻辑回归分析评估了使用治疗性大麻来管理艾滋病毒症状（即改善食欲/增加体重、诱导睡眠、缓解恶心/呕吐、缓解疼痛、缓解焦虑/抑郁/压力）与娱乐性大麻使用和ART依从性之间的关联。
约三分之一（33.2%）的参与者报告在过去3个月内使用过大麻。在大麻使用者中，21.8%报告仅为管理与艾滋病毒相关的医疗症状而使用大麻进行治疗，而78.2%报告为娱乐性使用。在控制协变量后，大麻的治疗性使用与ART依从性无关（调整后比值比[AOR]=1.19，95%置信区间[CI]=0.60 - 2.38，P = 0.602），而与非使用者相比，娱乐性大麻使用者显示出次优ART依从性的显著更高几率（AOR = 1.80，95% CI = 1.18 - 2.72，P = 0.005）。
我们的结果表明，报告娱乐性与治疗性大麻使用的个体在ART依从性方面存在差异。随着美国娱乐性和医用大麻合法化的扩散，继续研究艾滋病毒感染者中大麻使用对健康的影响很重要。
