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.
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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.
Conflict of interest
The authors declare that they have no conflict of interest.
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 was obtained from all individual participants included in the study.
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Adams, J.W., Bryant, K.J., Edelman, J.E. et al. Association of Cannabis, Stimulant, and Alcohol use with Mortality Prognosis Among HIV-Infected Men. AIDS Behav 22, 1341–1351 (2018). https://doi.org/10.1007/s10461-017-1905-4