Initiation of Regular Marijuana Use Among a Cohort of Women Infected with or at Risk for HIV in the Women's Interagency HIV Study (WIHS)

Abstract

Our study sought to determine the incidence of weekly marijuana use among HIV-infected and uninfected women, to identify correlates of weekly marijuana use, and to test its association with stage of HIV disease and type of HIV treatment received. A total of 2059 HIV-positive and 569 HIV-negative women from 6 sites were recruited between 1994 and 1995 and followed through 2000. After excluding women who reported weekly marijuana use at baseline, 2050 women were included in the analysis. The incidence rate for initiating marijuana was calculated and survival analysis was performed to determine the correlates of initiating weekly marijuana use. Three hundred and three women initiated weekly marijuana use within 5.5 years of the baseline visit, yielding a cumulative incidence (CI) of 14.8%. There was no significant difference in weekly marijuana use initiation between HIV-infected (CI = 14.5%) and HIV-uninfected women (CI = 16.0%). Younger age and having more sex partners was associated with incident weekly marijuana use among both infected and uninfected women. While undetectable viral load was associated with lower incidence rate (p < 0.001, RH = 0.44) and wasting syndrome with higher incidence (p < 0.01, relative hazard [RH] = 3.1), CD4 count was not. Compared to receiving no AIDS treatment at all, women who received basic combination antiretroviral therapy had significantly higher incidence of weekly marijuana use (p < 0.001, RH = 1.93), while highly active antiretroviral therapy (HAART) receivers had significantly lower incidence (p < 0.001, RH = 0.24). In summary, among HIV-infected women, the incidence of weekly marijuana use was associated with only one marker of HIV disease stage and HAART was associated with lower initiation rate of weekly marijuana use.

Prevalence and correlates of marijuana use among HIV-seropositive and seronegative men in the Multicenter AIDS Cohort Study (MACS), 1984–2013

“…Using data from a longitudinal cohort of HIV+ women, Kuo et al (2004) found lower initiation of weekly marijuana use among women with an undetectable HIV viral load and those receiving highly active antiretroviral therapy (HAART)(23). A follow-up study in HIV+ women found marijuana users to be less likely to be on ART, but daily marijuana use to be associated with higher CD4 count (6).…”

Substance use patterns and factors associated with changes over time in a cohort of heterosexual women at risk for HIV acquisition in the United States

“…Baseline data from WIHS revealed a high prevalence of drug use, with 28.9% of cohort participants reporting drug use in the previous six months, and among those who were HIV-negative, 25% reported crack use, 19.7% reported cocaine use, and 10.3% reported injection drug use at baseline (Wilson et al, 1999). Two studies of longitudinal patterns of drug use were conducted using WIHS data, but both focused on marijuana use, and one was conducted among HIV-positive participants only (D'Souza et al, 2012; W. H. Kuo et al, 2004).…”

Substance abuse, hepatitis C, and aging in HIV: common cofactors that contribute to neurobehavioral disturbances

“…Specifically, preclinical cellular and animal studies confirm that the active constituents of cannabis can suppress immune function, 174,175 promote lymphocyte apoptosis, 176 promote tumor growth, 177 and increase HIV receptor expression and replication. 175 Evidence in support of cannabis' deleterious health influences includes studies showing that among HIV+ patients, cannabis use is associated with more opportunistic infections, 178-180 sexually transmitted diseases, 181 poorer overall health, 182 increased HIV viral load, 183,184 lower CD4 counts 182 , and more rapid progression to AIDS. 185 Yet, others have failed to find relationships between cannabis use and increased risk of infection, 186-188 more rapid progression to AIDS, 189-191 or with immune biomarkers.…”

“…185 Yet, others have failed to find relationships between cannabis use and increased risk of infection, 186-188 more rapid progression to AIDS, 189-191 or with immune biomarkers. 183,192,193 The picture is further complicated by data showing that cannabinoids may be neuroprotective through inhibition of pro-inflammatory cytokine production 194-196 . Recently, an in vivo experimental investigation of rhesus macaques found that THC ameliorated SIV progression, decreased mortality, and improved retention of body mass.…”