Britton Mark K, DeFelice Jason, Porges Eric C, Cohen Ronald, Li Yancheng, Wang Yan, Ibañez Gladys E, Somboonwit Charurut, Cook Robert L
Center for Cognitive Aging and Memory, University of Florida, 1249 Center Drive, Gainesville, FL 32603, United States; Department of Epidemiology, University of Florida, 2004 Mowry Road, Gainesville, FL 32603, United States.
Center for Cognitive Aging and Memory, University of Florida, 1249 Center Drive, Gainesville, FL 32603, United States.
Drug Alcohol Depend. 2024 Aug 1;261:111354. doi: 10.1016/j.drugalcdep.2024.111354. Epub 2024 Jun 3.
Apathy is prevalent among people with HIV (PWH) and is associated with poor clinical outcomes. Cannabis use and Cannabis Use Disorder (CUD) are also disproportionately prevalent among PWH. CUD and younger onset of cannabis use may be linked to apathy in the general population; however, patterns of use most strongly associated with apathy have not been firmly established, and it is unclear whether cannabis use is linked to apathy in PWH.
We examined associations in 311 adult PWH between Apathy Evaluation Scale-Self (AES-S) scores and CUD history (current/past/no CUD/no cannabis use) and between AES-S scores and age of CUD onset (adolescent-onset/adult-onset). We also examined robustness of associations to adjustment for depressive symptoms (which may overlap with apathy symptoms) and alcohol use.
Current CUD was associated with greater AES-S scores relative to cannabis users with no CUD history (β = 2.13, 95 % CI = 0.37-3.90, p = 0.018). Adolescent-onset CUD was not associated with greater apathy relative to adult-onset CUD (β = 0.56, 95 % CI = -2.57 - 3.68, p = 0.7). Associations became nonsignificant after adjustment for depressive symptoms, but not after adjustment for alcohol use. Alcohol use was correlated with apathy (r = 0.19, 95 % CI: 0.076-0.29, p = 0.001).
Cannabis Use Disorder and at-risk alcohol use are associated with apathy among PWH; this finding highlights the need for substance use disorder prevention and treatment among PWH.
冷漠在艾滋病毒感染者（PWH）中很普遍，且与不良临床结局相关。大麻使用和大麻使用障碍（CUD）在PWH中也不成比例地普遍存在。在普通人群中，CUD和较早开始使用大麻可能与冷漠有关；然而，与冷漠最密切相关的使用模式尚未完全确定，目前尚不清楚大麻使用是否与PWH中的冷漠有关。
我们在311名成年PWH中研究了自我冷漠评估量表（AES-S）得分与CUD病史（当前/过去/无CUD/无大麻使用）之间以及AES-S得分与CUD发病年龄（青少年发病/成人发病）之间的关联。我们还研究了在调整抑郁症状（可能与冷漠症状重叠）和酒精使用后关联的稳健性。
与无CUD病史的大麻使用者相比，当前CUD与更高的AES-S得分相关（β = 2.13，95% CI = 0.37 - 3.90，p = 0.018）。与成人发病的CUD相比，青少年发病的CUD与更高的冷漠无关（β = 0.56，95% CI = -2.57 - 3.68，p = 0.7）。在调整抑郁症状后，关联变得不显著，但在调整酒精使用后并非如此。酒精使用与冷漠相关（r = 0.19，95% CI：0.076 - 0.29，p = 0.001）。
大麻使用障碍和有风险的酒精使用与PWH中的冷漠有关；这一发现凸显了在PWH中预防和治疗物质使用障碍的必要性。
