Mian M N, Sarovar V, Levine T, Lea A, Leibowitz A, Luu M, Flamm J, Hare C B, Horberg M, Young-Wolff K C, Phillips K T, Silverberg M J, Satre D D
Division of Research, Kaiser Permanente Northern California, Pleasanton, California, Pleasanton CA.
Department of Psychiatry and Behavioral Sciences, Weill Institute for Neurosciences, University of California, San Francisco, CA, USA.
Res Sq. 2024 May 29:rs.3.rs-4415444. doi: 10.21203/rs.3.rs-4415444/v1.
While cannabis use is prevalent among people with HIV (PWH), factors associated with higher-risk use require further study. We examined factors associated with indicators risk for cannabis use disorder (CUD) among PWH who used cannabis.
Participants included adult (≥18 years old) PWH from 3 HIV primary care clinics in Kaiser Permanente Northern California who reported past three-month cannabis use through the computerized Tobacco, Alcohol, Prescription medication, and other Substance use (TAPS) screening. Primary outcome was TAPS cannabis score (range 1-3), categorized as any use (1) and higher risk for CUD (≥2). Measures included sociodemographics (age, sex, race, neighborhood deprivation index [NDI]), Charlson Comorbidity Index (CCI), HIV RNA, CD4 cell counts, higher risk tobacco use (TAPS tobacco score≥2), depression, and anxiety symptoms. Unadjusted and multivariable logistic regression examined factors associated with higher risk for CUD.
Of the complete sample (=978; 94.1% Male; 58.3% White; Age =51-60), 35.8% reported higher risk for CUD. Unadjusted models indicated younger age, Black race, higher CCI, depression, anxiety, and higher risk tobacco use were associated with higher risk, while only Black race (OR=1.84, 95% CI[1.29, 2.63]), anxiety (OR=1.91, 95% CI[1.22, 2.98]), and higher risk tobacco use (OR=2.27, 95% CI[1.47, 3.51]) remained significant in the multivariable model.
Black race, anxiety and tobacco use, but not HIV clinical markers, were associated with higher risk for CUD among PWH. Clinical efforts to screen and provide interventions for preventing CUD alongside anxiety and tobacco use among PWH should be evaluated.
虽然大麻使用在艾滋病毒感染者（PWH）中很普遍，但与高风险使用相关的因素仍需进一步研究。我们研究了在使用大麻的PWH中，与大麻使用障碍（CUD）指标风险相关的因素。
参与者包括来自北加利福尼亚凯撒医疗集团3家艾滋病毒初级保健诊所的成年（≥18岁）PWH，他们通过计算机化的烟草、酒精、处方药和其他物质使用（TAPS）筛查报告了过去三个月的大麻使用情况。主要结局是TAPS大麻评分（范围为1 - 3），分为任何使用（1）和CUD高风险（≥2）。测量指标包括社会人口统计学特征（年龄、性别、种族、邻里贫困指数[NDI]）、查尔森合并症指数（CCI）、艾滋病毒RNA、CD4细胞计数、高风险烟草使用（TAPS烟草评分≥2）、抑郁和焦虑症状。未调整和多变量逻辑回归分析了与CUD高风险相关的因素。
在完整样本（n = 978；94.1%为男性；58.3%为白人；年龄 = 51 - 60岁）中，35.8%报告有CUD高风险。未调整模型表明，年龄较小、黑人种族、较高的CCI、抑郁、焦虑和高风险烟草使用与高风险相关，而在多变量模型中，只有黑人种族（OR = 1.84，95% CI[1.29, 2.63]）、焦虑（OR = 1.91，95% CI[1.22, 2.98]）和高风险烟草使用（OR = 2.27，95% CI[1.47, 3.51]）仍然显著。
黑人种族、焦虑和烟草使用，而非艾滋病毒临床标志物，与PWH中CUD的高风险相关。应评估针对PWH中焦虑和烟草使用情况进行筛查并提供预防CUD干预措施的临床努力。
