Morgan Ethan, Eaton Lisa A, Watson Ryan J
College of Nursing, The Ohio State University, Columbus, OH, USA.
Infectious Disease Institute, The Ohio State University, Columbus, OH, USA.
AIDS Behav. 2023 Dec;27(12):4033-4040. doi: 10.1007/s10461-023-04117-w. Epub 2023 Jul 8.
To achieve stated targets in the United States of Ending the HIV Epidemic by 2030, it is necessary to decrease rates of pre-exposure prophylaxis use (PrEP) cessation. In particular, it is key to assess PrEP use and cannabis use frequency given the recent wave of cannabis decriminalization across the U.S., particularly among sexual minority men and gender diverse (SMMGD) individuals. We used data from the baseline visit of a national study of Black and Hispanic/Latino SMMGD. Among participants reporting any lifetime cannabis use, we further assessed the association between frequency of cannabis use in the past 3 months and: (1) self-reported PrEP use, (2) recency of last PrEP dose, and (3) HIV status using adjusted regression models. Compared to those who never used cannabis, odds of PrEP cessation were higher among those who used it once or twice (aOR 3.27; 95% CI 1.38, 7.78), those who used it monthly (aOR 3.41; 95% CI 1.06, 11.01), and those who used it weekly or more frequently (aOR 2.34; 95% CI 1.06, 5.16). Similarly, those reporting cannabis use 1-2 times in the past 3 months (aOR 0.11; 95% CI 0.02, 0.58) and those reporting weekly or more frequent use (aOR 0.14; 95% CI 0.03, 0.68) were each more likely to report more recent PrEP cessation. These results suggest that cannabis users in general may be a population at elevated risk of HIV diagnosis although more research regarding these findings is needed with nationally representative populations.
为了在美国实现到2030年结束艾滋病流行的既定目标，有必要降低暴露前预防用药（PrEP）的停药率。鉴于近期美国各地一波大麻合法化浪潮，尤其是在性少数男性和性别多样化（SMMGD）个体中，评估PrEP使用情况和大麻使用频率至关重要。我们使用了一项针对黑人和西班牙裔/拉丁裔SMMGD的全国性研究基线访视的数据。在报告有过终身大麻使用经历的参与者中，我们进一步使用调整后的回归模型评估了过去3个月内大麻使用频率与以下因素之间的关联：（1）自我报告的PrEP使用情况，（2）最后一剂PrEP的最近使用时间，以及（3）HIV感染状况。与从未使用过大麻的人相比，曾经使用过一两次大麻的人（调整后比值比[aOR]为3.27；95%置信区间[CI]为1.38，7.78）、每月使用大麻的人（aOR为3.41；95%CI为1.06，11.01）以及每周或更频繁使用大麻的人（aOR为2.34；95%CI为1.06，5.16）中，PrEP停药的几率更高。同样，在过去3个月内报告使用大麻1 - 2次的人（aOR为0.11；95%CI为0.02，0.58）以及报告每周或更频繁使用大麻的人（aOR为0.14；95%CI为0.03，0.68）更有可能报告最近停止使用PrEP。这些结果表明，一般而言大麻使用者可能是HIV诊断风险较高的人群，尽管需要对这些发现进行更多涉及全国代表性人群的研究。
