The Impact of Marijuana Use on the Successful Aging of HIV-Infected Adults

Abstract

Objective To determine the impact of self-reported marijuana use on the components of successful aging of human immunodeficiency virus-infected persons. Methods Cross-sectional study of 45- to 65-year-old HIV-infected subjects on anti-retroviral therapy >6 months with undetectable HIV-1 viral load. Successful aging was defined as absence of disease; adequate physical function; high Quality of Life (QOL) and social engagement. Clinical characteristics, physical function assessments, and QOL from short-form 36 (SF-36) were compared between groups defined by self-reported Recent Marijuana Use (RMU), adjusted for tobacco use, CD4+ T-cell count and time since HIV diagnosis, using logistic or linear regression for binary or continuous measures. Results 93 of 359 total subjects (26%) reported RMU. Demographically, patients reporting RMU had been diagnosed with HIV less recently (14 [13–16] vs 11 [10–12] years), reported smoking (48% vs 25%) and lower income (92% vs 80%) with greater prevalence than non-RMU patients; other demographics and clinical characteristics (age, CD4+ T-cell count) were similar. Gender, race/ethnicity, physical outcomes, physical function and disease burden were not significantly different. Patients reporting RMU demonstrated lower mental QOL and increased odds of low social engagement and un- or underemployment compared to non-users. Conclusions The negative association between RMU and mental or social QOL should be considered when assessing the success with which HIV patients reporting RMU are aging.

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

“…Observational studies of HIV+ individuals cite therapeutic benefits of marijuana; including relief of HIV-related symptoms and side effects of ART (6,9,11,12,14), although empirical data on the efficacy and safety of use is limited (15). Importantly, marijuana use among HIV+ individuals has been associated with reduced ART adherence (16–18), cognitive impairment (19,20) and poorer quality of life (21). …”

“…Past studies of correlates of marijuana use among HIV+ individuals have found younger age (16,22), lower educational level (16), alcohol, cigarette and other illicit substances to be positively associated with marijuana use (9,16,21), although most of these studies have been cross sectional. 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).…”

Healthy Aging in Older Women Living with HIV Infection: a Systematic Review of Psychosocial Factors

“…Lastly, healthy or successful aging with HIV has been identified as one of key interest areas by the NIH Working Group on HIV and Aging [1]. However, only a handful of studies exist to date that assess psychosocial aspects of successful aging in PLWH [72–75] and none of them focused specifically on OWLH.…”

A Comparison of Motivations for Marijuana Use in HIV-Positive and HIV-Negative Adults

“…A modified version of the 36-Item Short Form Health Survey Version 2 (SF-36v2) assessed past month physical and mental health functioning [32]. The SF-36v2 is a reliable and well-validated measure that has been used extensively with HIV+ populations [e.g., 33,34,35]. The measure is comprised of eight subscales: Physical Functioning, Role-Physical (role limitations due to physical health), Bodily Pain, General Health (perception of health), Vitality (energy/fatigue), Mental Health, Social Functioning, and Role-Emotional (role limitations due to mental health).…”