AIDS and Behavior

, Volume 22, Issue 4, pp 1341–1351 | Cite as

Association of Cannabis, Stimulant, and Alcohol use with Mortality Prognosis Among HIV-Infected Men

  • Joëlla W. Adams
  • Kendall J. Bryant
  • Jennifer E. Edelman
  • David A. Fiellin
  • Julie R. Gaither
  • Adam J. Gordon
  • Kirsha S. Gordon
  • Kevin L. Kraemer
  • Matthew J. Mimiaga
  • Don Operario
  • Janet P. Tate
  • Jacob J. van den Berg
  • Amy C. Justice
  • Brandon D. L. Marshall
Original Paper


Questionnaires over a 9-year study period (2002–2010) were used to characterize cannabis, stimulant, and alcohol use among 3099 HIV-infected men participating in the Veterans Aging Cohort Study (VACS) to determine whether use of these substances is associated with changes in the VACS Index, a validated prognostic indicator for all-cause mortality. At baseline, 18% of participants reported no substance use in the past year, 24% lower risk alcohol use only, 18% unhealthy alcohol use only, 15% cannabis use (with or without alcohol), and 24% stimulant use (with or without alcohol or cannabis). In adjusted longitudinal analyses, cannabis use [β = −0.97 (95% CI −1.93, 0.00), p = 0.048] was not associated with mortality risk, while stimulant use [1.08 (0.16, 2.00), p = 0.021] was associated with an increased mortality risk, compared to lower risk alcohol use. Our findings show no evidence of a negative effect of cannabis use on mortality risk, while stimulant use was associated with increased mortality risk among HIV-infected men. Interventions to reduce stimulant use in this patient population may reduce mortality.


Alcohol Cannabis Drug use Men who have sex with men HIV/AIDS 



We would like to acknowledge the veterans who participate in the Veterans Aging Cohort Study (VACS) and the study coordinators and staff at each VACS site and at the West Haven Coordinating Center. This work was supported by grants from the National Institute on Alcohol Abuse and Alcoholism (NIAAA: U24-AA022000, U10-AA013566, U01-AA020795, U01-AA020790, U24-AA020794, and P01-AA019072), the National Institute of Allergy and Infectious Diseases (P30-AI042853), and in kind by the U.S. Department of Veterans Affairs.


The views expressed in this article are those of the authors and do not necessarily reflect the position or policy of the Department of Veterans Affairs.

Compliance with Ethical Standards

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical Approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed Consent

Informed consent was obtained from all individual participants included in the study.

Supplementary material

10461_2017_1905_MOESM1_ESM.docx (14 kb)
Supplementary material 1 (DOCX 13 kb)


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Copyright information

© Springer Science+Business Media, LLC 2017

Authors and Affiliations

  • Joëlla W. Adams
    • 1
  • Kendall J. Bryant
    • 2
  • Jennifer E. Edelman
    • 3
  • David A. Fiellin
    • 3
  • Julie R. Gaither
    • 4
  • Adam J. Gordon
    • 5
    • 6
  • Kirsha S. Gordon
    • 7
  • Kevin L. Kraemer
    • 8
  • Matthew J. Mimiaga
    • 1
  • Don Operario
    • 1
  • Janet P. Tate
    • 3
    • 7
  • Jacob J. van den Berg
    • 1
  • Amy C. Justice
    • 3
    • 7
  • Brandon D. L. Marshall
    • 1
  1. 1.Brown University School of Public HealthProvidenceUSA
  2. 2.National Institute on Alcohol Abuse and AlcoholismNational Institutes of HealthRockvilleUSA
  3. 3.Division of General Internal Medicine and the Center for Interdisciplinary Research on AIDSYale University School of MedicineNew HavenUSA
  4. 4.Department of Epidemiology of Microbial Diseases, Yale School of Public HealthYale UniversityNew HavenUSA
  5. 5.Center for Health Equity Research and PromotionPittsburgh VA Healthcare SystemPittsburghUSA
  6. 6.Division of General Internal Medicine, Department of Medicine, Center for Research on Health CareUniversity of PittsburghPittsburghUSA
  7. 7.Veterans Aging Cohort Study Coordinating CenterVeterans Administration Connecticut Healthcare SystemWest HavenUSA
  8. 8.VA Pittsburgh Healthcare SystemPittsburghUSA

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