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AIDS and Behavior

, Volume 22, Issue 4, pp 1363–1372 | Cite as

Regular Marijuana Use is Associated with Poor Viral Suppression in HIV-Infected Adolescents and Young Adults

  • Amelia B. Thompson
  • Scott E. Gillespie
  • Jasper Hood
  • LaTeshia Thomas-Seaton
  • Sophia A. Hussen
  • Andres F. Camacho-Gonzalez
Original Paper

Abstract

There is a paucity of data regarding the impact of drug use on HIV suppression and care retention among adolescents and young adults (AYAs). We recruited a clinic-based sample of HIV infected AYAs to assess the prevalence of self-reported drug use. Clinical data, including retention and viral suppression, were abstracted from the electronic medical record. Logistic regression was used to evaluate marijuana and illicit drug use associations and to identify other risk factors. Of 200 participants (mean age 21, 2.4 years, 69% horizontally infected), 46% reported current drug use, with marijuana as the most commonly used drug. Any illicit drug use (aOR 1.99, 95% CI 1.06–3.73, p = 0.032) and lower education (aOR 2.11, 95% CI 1.09–4.08, p = 0.046) were associated with poor viral suppression in multivariable analyses. Considering marijuana use only, an association with poor viral suppression was more pronounced (aOR 2.10, 95% CI 1.12–3.94, p = 0.021). Drug use did not have a significant association with retention in care, but AYAs who were retained in HIV care were less likely to have poorly suppressed HIV (aOR 0.22, 95% CI 0.10–0.49, p < 0.001). High prevalence of marijuana use among HIV infected AYAs, and its association with poorly suppressed HIV, demonstrates the need for intervention strategies to decrease its consumption.

Keywords

HIV Adolescents Retention Drug use Marijuana 

Resumen

Existe una carencia de información sobre el impacto del consumo de drogas ilícitas en la obtención de una carga viral no detectable y en la retención en cuidado médico de adolescentes y adultos jóvenes (AAJ) con VIH. Este estudio reclutó AAJ VIH positivos para evaluar la prevalencia del uso de drogas ilícitas. Igualmente se analizó la asociación entre su consumo, u otros posibles factores de riesgo, con la presencia de una carga viral detectable y la falta de retención en cuidado médico. Datos clínicos incluyendo carga viral y retención en cuidado médico fueron abstraídos de la historia clínica. De 200 participantes (edad promedio 21± 2.4 años, 69% infectados de manera horizontal), 46% reportaron uso actual de drogas ilícitas, siendo marihuana la droga más comúnmente utilizada. El resultado del análisis multivariable asoció el uso de cualquier droga ilícita (aOR = 1.99, 95% CI: 1.06-3.73, p = 0.032), y el tener un bajo nivel educativo (aOR = 2.11, 95% IC: 1.09-4.08, p = 0.046) con la presencia de una carga viral detectable. Al considerar únicamente el consumo de marihuana, la asociación con un control viral inadecuado fue más pronunciada (aOR = 2.10, 95% CI: 1.12-3.94, p = 0.021). El uso de drogas ilícitas no mostró una asociación significativa con la retención en cuidado médico, pero los AAJ que se mantuvieron en cuidado médico presentaron una menor probabilidad de tener control inapropiado del VIH (aOR = 0.22, 95% CI: 0.10-0.49, p < 0.001). La alta prevalencia del uso de marihuana entre AAJ VIH positivos, y su asociación con un control viral inadecuado, demuestran la necesidad de desarrollar estrategias de intervención enfocadas a disminuir su consumo.

Notes

Acknowledgements

We gratefully acknowledge all the study participants for the time and effort required to complete the survey. We also thank Ann Chahroudi, Jumi Yi, Christopher Prestel, Candace Speight and Nikita Malcolm for assistance with this study and manuscript review.

Authors’ Contribution

ABT conceptualized and designed the study, collected and analyzed the data, and drafted the initial manuscript. SEG analyzed the data. JH and LS helped to collect the data, AFCG conceptualized and designed the study and helped edit the manuscript. SH gave input into data analysis and helped edit the manuscript. ABT, SEG, JH, LS, SH and AFCG reviewed and revised the manuscript, and approved the final manuscript as submitted.

Compliance with Ethical Standards

Conflicts of interest

Andres F. Camacho-Gonzalez has received research support from Gilead Sciences (Notice of Award: 380-37362) and Janssen Pharmaceuticals (Notice of Award: 39688).

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.

References

  1. 1.
    Centers for Disease Control and Prevention. Monitoring selected national HIV prevention and care objectives by using HIV surveillance data—United States and 6 dependent areas—2014. HIV Surveillance Supplemental Report. 2016;21(4).Google Scholar
  2. 2.
    Zanoni BC, Mayer KH. The adolescent and young adult HIV cascade of care in the United States: exaggerated health disparities. AIDS Patient Care STDS. 2014;28(3):128–35.CrossRefPubMedPubMedCentralGoogle Scholar
  3. 3.
    Boyer CB, Walker BC, Chutuape KS, Roy J, Fortenberry JD, Adolescent Medicine Trials Network for HIVAI. Creating systems change to support goals for HIV continuum of care: the role of community coalitions to reduce structural barriers for adolescents and young adults. J HIV AIDS Soc Serv. 2016;15(2):158–79.CrossRefPubMedPubMedCentralGoogle Scholar
  4. 4.
    Fortenberry JD, Martinez J, Rudy BJ, Monte D, Adolescent Trials Network for HIVAI. Linkage to care for HIV-positive adolescents: a multisite study of the adolescent medicine trials units of the adolescent trials network. J Adolesc Health. 2012;51(6):551–6.CrossRefPubMedPubMedCentralGoogle Scholar
  5. 5.
    Magnus M, Jones K, Phillips G 2nd, et al. Characteristics associated with retention among African American and Latino adolescent HIV-positive men: results from the outreach, care, and prevention to engage HIV-seropositive young MSM of color special project of national significance initiative. J Acquir Immune Defic Syndr. 2010;53(4):529–36.CrossRefPubMedGoogle Scholar
  6. 6.
    Johnson AS, Hall HI, Hu X, Lansky A, Holtgrave DR, Mermin J. Trends in diagnoses of HIV infection in the United States, 2002–2011. JAMA. 2014;312(4):432–4.CrossRefPubMedGoogle Scholar
  7. 7.
    Kann L, McManus T, Harris WA, et al. Youth risk behavior surveillance—United States, 2015. MMWR Surveill Summ. 2016;65(6):1–174.CrossRefGoogle Scholar
  8. 8.
    Gamarel KE, Brown L, Kahler CW, et al. Prevalence and correlates of substance use among youth living with HIV in clinical settings. Drug Alcohol Depend. 2016;169:11–8.CrossRefPubMedPubMedCentralGoogle Scholar
  9. 9.
    Gourdet C, Giombi KC, Kosa K, Wiley J, Cates S. How four US states are regulating recreational marijuana edibles. Int J Drug Policy. 2017;43:83–90.CrossRefPubMedGoogle Scholar
  10. 10.
    Ryan SA, Ammerman SD, Committee On Substance USE, Prevention. Counseling parents and teens about marijuana use in the era of legalization of marijuana. Pediatrics. 2017;139(3):e20164069.CrossRefPubMedGoogle Scholar
  11. 11.
    Cerda M, Wall M, Feng T, et al. Association of State recreational marijuana laws with adolescent marijuana use. JAMA Pediatr. 2017;171(2):142–9.CrossRefPubMedPubMedCentralGoogle Scholar
  12. 12.
    Bull SS, Brooks-Russell A, Davis JM, Roppolo R, Corsi K. Awareness, perception of risk and behaviors related to retail marijuana among a sample of Colorado youth. J Community Health. 2017;42(2):278–86.CrossRefPubMedGoogle Scholar
  13. 13.
    Morean ME, Kong G, Camenga DR, Cavallo DA, Krishnan-Sarin S. High school students’ use of electronic cigarettes to vaporize cannabis. Pediatrics. 2015;136(4):611–6.CrossRefPubMedPubMedCentralGoogle Scholar
  14. 14.
    Wang GS. Pediatric concerns due to expanded cannabis use: unintended consequences of legalization. J Med Toxicol. 2017;13(1):99–105.CrossRefPubMedGoogle Scholar
  15. 15.
    Barrus DG, Capogrossi KL, Cates SC, et al. Tasty THC: promises and challenges of cannabis edibles. Methods Reports RTI Press; 2016.Google Scholar
  16. 16.
    Gross IM, Hosek S, Richards MH, Fernandez MI. Predictors and profiles of antiretroviral therapy adherence among African American adolescents and young adult males living with HIV. AIDS Patient Care STDS. 2016;30(7):324–38.CrossRefPubMedPubMedCentralGoogle Scholar
  17. 17.
    Morgan E, Khanna AS, Skaathun B, et al. Marijuana use among young black men who have sex with men and the HIV care continuum: findings from the uConnect cohort. Subst Use Misuse. 2016;51(13):1751–9.CrossRefPubMedPubMedCentralGoogle Scholar
  18. 18.
    Bruce D, Kahana SY, Bauermeister JA, et al. Neighborhood-level and individual-level correlates of cannabis use among young persons living with HIV/AIDS. Drug Alcohol Depend. 2015;151:173–80.CrossRefPubMedPubMedCentralGoogle Scholar
  19. 19.
    Bonn-Miller MO, Oser ML, Bucossi MM, Trafton JA. Cannabis use and HIV antiretroviral therapy adherence and HIV-related symptoms. J Behav Med. 2014;37(1):1–10.CrossRefPubMedGoogle Scholar
  20. 20.
    Kipp AM, Rebeiro PF, Shepherd BE, et al. Daily marijuana use is associated with missed clinic appointments among HIV-infected persons engaged in HIV care. AIDS Behav. 2017;21(7):1996–2004.CrossRefPubMedGoogle Scholar
  21. 21.
    D’Souza G, Matson PA, Grady CD, et al. Medicinal and recreational marijuana use among HIV-infected women in the Women’s Interagency HIV Study (WIHS) cohort, 1994–2010. J Acquir Immune Defic Syndr. 2012;61(5):618–26.CrossRefPubMedPubMedCentralGoogle Scholar
  22. 22.
    Tucker JS, Burnam MA, Sherbourne CD, Kung FY, Gifford AL. Substance use and mental health correlates of nonadherence to antiretroviral medications in a sample of patients with human immunodeficiency virus infection. Am J Med. 2003;114(7):573–80.CrossRefPubMedGoogle Scholar
  23. 23.
    Rosen MI, Black AC, Arnsten JH, et al. Association between use of specific drugs and antiretroviral adherence: findings from MACH 14. AIDS Behav. 2013;17(1):142–7.CrossRefPubMedPubMedCentralGoogle Scholar
  24. 24.
    de Jong BC, Prentiss D, McFarland W, Machekano R, Israelski DM. Marijuana use and its association with adherence to antiretroviral therapy among HIV-infected persons with moderate to severe nausea. J Acquir Immune Defic Syndr. 2005;38(1):43–6.CrossRefPubMedGoogle Scholar
  25. 25.
    Lake S, Kerr T, Capler R, Shoveller J, Montaner J, Milloy MJ. High-intensity cannabis use and HIV clinical outcomes among HIV-positive people who use illicit drugs in Vancouver, Canada. Int J Drug Policy. 2017;42:63–70.CrossRefPubMedGoogle Scholar
  26. 26.
    Vidot DC, Lerner B, Gonzalez R. Cannabis use, medication management and adherence among persons living with HIV. AIDS Behav. 2017;21(7):2005–13.CrossRefPubMedGoogle Scholar
  27. 27.
    Moberg D. Adolescent Alcohol and Drug Involvement Scale. In: Center for Health Policy and Program Evaluation UoWMS, editor. Adapted with permission from Mayer and Filstead’s. Adolescent Alcohol Involvement Scale. J Stud Alcohol 1979;40:291–300; and Moberg and Hahn’s. Adolescent Drug Involvement Scale. J Adolesc Chem Depend 1991;2:75–88.Google Scholar
  28. 28.
    Harris RA, Xue X, Selwyn PA. Housing stability and medication adherence among HIV-positive individuals in antiretroviral therapy: a meta-analysis of observational studies in the United States. J Acquir Immune Defic Syndr. 2017;74(3):309–17.CrossRefPubMedGoogle Scholar
  29. 29.
    Mugavero MJ, Davila JA, Nevin CR, Giordano TP. From access to engagement: measuring retention in outpatient HIV clinical care. AIDS Patient Care STDS. 2010;24(10):607–13.CrossRefPubMedPubMedCentralGoogle Scholar
  30. 30.
    Wilkinson ST, Yarnell S, Radhakrishnan R, Ball SA, D’Souza DC. Marijuana legalization: impact on physicians and public health. Annu Rev Med. 2016;67:453–66.CrossRefPubMedGoogle Scholar
  31. 31.
    Castellanos-Ryan N, Pingault JB, Parent S, Vitaro F, Tremblay RE, Seguin JR. Adolescent cannabis use, change in neurocognitive function, and high-school graduation: a longitudinal study from early adolescence to young adulthood. Dev Psychopathol. 2016;29:1–14.Google Scholar
  32. 32.
    Ferrand RA, Briggs D, Ferguson J, et al. Viral suppression in adolescents on antiretroviral treatment: review of the literature and critical appraisal of methodological challenges. Trop Med Int Health. 2016;21(3):325–33.CrossRefPubMedPubMedCentralGoogle Scholar
  33. 33.
    Koster ES, Philbert D, de Vries TW, van Dijk L, Bouvy ML. “I just forget to take it”: asthma self-management needs and preferences in adolescents. J Asthma. 2015;52(8):831–7.CrossRefPubMedGoogle Scholar
  34. 34.
    Quinn K, Voisin DR, Bouris A, Schneider J. Psychological distress, drug use, sexual risks and medication adherence among young HIV-positive black men who have sex with men: exposure to community violence matters. AIDS Care. 2016;28:1–7.CrossRefGoogle Scholar
  35. 35.
    Krain A, Fitzgerald DW. HIV antiretroviral therapy in resource-limited settings: experiences from Haiti. Curr HIV/AIDS Rep. 2005;2(2):98–104.CrossRefPubMedGoogle Scholar
  36. 36.
    Mokrysz C, Freeman TP, Korkki S, Griffiths K, Curran HV. Are adolescents more vulnerable to the harmful effects of cannabis than adults? A placebo-controlled study in human males. Transl Psychiatry. 2016;6(11):e961.CrossRefPubMedPubMedCentralGoogle Scholar
  37. 37.
    Morgan E, Skaathun B, Michaels S, et al. Marijuana use as a sex-drug is associated with HIV risk among black MSM and their network. AIDS Behav. 2016;20(3):600–7.CrossRefPubMedPubMedCentralGoogle Scholar
  38. 38.
    Farrelly MC, Duke JC, Nonnemaker J, et al. Association between the real cost media campaign and smoking initiation among youths—United States, 2014–2016. MMWR Morb Mortal Weekly Rep. 2017;66(2):47–50.CrossRefGoogle Scholar
  39. 39.
    Huang LL, Lazard AJ, Pepper JK, Noar SM, Ranney LM, Goldstein AO. Impact of the real cost campaign on adolescents’ recall, attitudes, and risk perceptions about tobacco use: a national study. Int J Environ Res Public Health. 2017;14(1):42.CrossRefPubMedCentralGoogle Scholar
  40. 40.
    van der Heide I, Wang J, Droomers M, Spreeuwenberg P, Rademakers J, Uiters E. The relationship between health, education, and health literacy: results from the Dutch adult literacy and life skills survey. J Health Commun. 2013;18(Suppl 1):172–84.CrossRefPubMedPubMedCentralGoogle Scholar
  41. 41.
    Kalichman SC, Benotsch E, Suarez T, Catz S, Miller J, Rompa D. Health literacy and health-related knowledge among persons living with HIV/AIDS. Am J Prev Med. 2000;18(4):325–31.CrossRefPubMedGoogle Scholar
  42. 42.
    Kalichman SC, Pope H, White D, et al. Association between health literacy and HIV treatment adherence: further evidence from objectively measured medication adherence. J Int Assoc Physicians AIDS Care (Chic). 2008;7(6):317–23.CrossRefGoogle Scholar
  43. 43.
    Baumann KE, Phillips AL, Arya M. Overlap of HIV and low health literacy in the southern USA. Lancet HIV. 2015;2(7):e269–70.CrossRefPubMedPubMedCentralGoogle Scholar
  44. 44.
    Navarra AM, Neu N, Toussi S, Nelson J, Larson EL. Health literacy and adherence to antiretroviral therapy among HIV-infected youth. J Assoc Nurses AIDS Care. 2014;25(3):203–13.CrossRefPubMedGoogle Scholar
  45. 45.
    Murphy DA, Lam P, Naar-King S, et al. Health literacy and antiretroviral adherence among HIV-infected adolescents. Patient Educ Couns. 2010;79(1):25–9.CrossRefPubMedGoogle Scholar
  46. 46.
    Eisenstein TK, Meissler JJ. Effects of cannabinoids on T-cell function and resistance to infection. J Neuroimmune Pharmacol. 2015;10(2):204–16.CrossRefPubMedPubMedCentralGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC 2017

Authors and Affiliations

  • Amelia B. Thompson
    • 1
    • 2
    • 3
  • Scott E. Gillespie
    • 4
  • Jasper Hood
    • 2
    • 3
  • LaTeshia Thomas-Seaton
    • 3
    • 5
  • Sophia A. Hussen
    • 3
    • 6
  • Andres F. Camacho-Gonzalez
    • 2
    • 3
  1. 1.Division of Pediatric Infectious Diseases, Department of PediatricsDuke University School of MedicineDurhamUSA
  2. 2.Division of Pediatric Infectious Diseases, Department of PediatricsEmory University School of MedicineAtlantaUSA
  3. 3.Ponce Family and Youth Clinic, Grady Infectious Diseases ProgramGrady Health SystemsAtlantaUSA
  4. 4.Department of PediatricsEmory University School of MedicineAtlantaUSA
  5. 5.Children’s Healthcare of AtlantaAtlantaUSA
  6. 6.Hubert Department of Global HealthEmory University Rollins School of Public HealthAtlantaUSA

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