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Colonna R, Knott M, Kim S, Bagajati R. Qualitative Research on Cannabis Use Among Youth: A Methodological Review. JOURNAL OF DRUG ISSUES 2022. [DOI: 10.1177/00220426221139420] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Recreational cannabis legalization has encouraged research regarding cannabis use among youth, especially the use of qualitative approaches. In fact, alcohol and drug use journals have recently encouraged qualitative submissions and provided criteria to ensure “high-quality” research. This study provides an objective account of the qualitative approaches used by researchers in this field and discusses implications for future research. A methodological review was conducted for studies published between January 2010 and November 2019. Targeted keyword searches in four research databases returned 1956 unique records. Pairs of reviewers independently screened records against eligibility criteria and charted data for study philosophical positioning, methodology, study aims, sampling, sample, data collection, and data analysis. 23 studies met the inclusion criteria. Several gaps in study quality criteria are observed: less than half of the studies specified the overarching methodology and just two stated philosophical positioning, with some methods unjustified. Implications for future research are discussed.
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Affiliation(s)
- Robert Colonna
- Health and Rehabilitation Sciences, Western University, London, ON, Canada
| | - Melissa Knott
- Health and Rehabilitation Sciences, Western University, London, ON, Canada
| | - Sean Kim
- Schulich School of Medicine and Dentistry, Western University, London, ON, Canada
| | - Reem Bagajati
- School of Occupational Therapy, Western University, London, ON, Canada
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Vallée A. Sexual behaviors, cannabis, alcohol and monkeypox infection. Front Public Health 2022; 10:1054488. [PMID: 36733281 PMCID: PMC9887129 DOI: 10.3389/fpubh.2022.1054488] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2022] [Accepted: 12/28/2022] [Indexed: 01/18/2023] Open
Abstract
The emergence of the monkeypox virus (MPXV) outbreak in 2022 is a worldwide health issue. The rapid increase of monkeypox cases caused the WHO to designate the escalating global monkeypox outbreak a Public Health Emergency of International Concern on July 23, 2022. The WHO has called on the group currently most affected by the virus, men who have sex with men (MSM), to limit their sexual partners. The diminution in number of sexual partners not only decreases the proportion of infected MSM but could also increases the number of days needed to reach a given infection level among the general population. Several behavioral factors could be associated with high levels of different sexual partners, such as cannabis use and alcohol consumption. Firstly, this review focuses on the association between cannabis and alcohol consumption and the number of sexual partners, and their possible impact on the current MPXV outbreak by impairing the immune responses. Secondly, this review investigated in the UK Biobank cohort the relationship between alcohol and cannabis use and the number of sexual partners. Among the 115,604 participants, 1.8% declared to be MSM, 1.9% to be WSW (women having sex with women), 43.3% men heterosexuals and 53.0% women heterosexuals. MSM and WSW showed higher lifetime sexual partners (N = 17.4 (SD:17.52) and N = 13.65 (SD: 13.21), respectively) compared to heterosexual men (N = 6.89 (SD: 9.47) and women (N = 5.19 (SD:6.56), p < 0.001. After adjustment for age, body mass index, lifetime sexual activity, educational and income levels, tobacco and cardiovascular diseases, cannabis use and alcohol consumption remained significantly associated with increase in the number of different sexual partners in all four subgroups. Thus, cannabis use and alcohol consumption may have two detrimental effects on the MPXV outbreak: by participating in the increase of the number of sexual partners which are mainly responsible for the augmentation of the number of new MPXV infected cases and by impairing the immune response to a viral infection. Health and safety policies should address the factors and practices, including chemsex, leading to an increase in risk of sexual behaviors responsible for MPXV dissemination in the worldwide population.
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Firkey M, Sheinfil A, Ramos J, Woolf-King SE. Cannabis and Alcohol Co-Use and Condomless Anal Sex Among Men Who have Sex with Men Living with HIV: An Event-Level Analysis. AIDS Behav 2021; 25:3770-3781. [PMID: 33733310 DOI: 10.1007/s10461-021-03228-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/10/2021] [Indexed: 10/21/2022]
Abstract
Men who have sex with men (MSM) account for more than two thirds of new HIV diagnoses annually. Sexual behavior that increases risk for onward transmission of HIV is associated with both alcohol and cannabis use. However, little is known about the influence of cannabis and alcohol co-use on engagement in condomless anal sex (CAS). The current study explored daily associations between substance use and CAS among HIV-positive MSM using a 42-day timeline followback interview (N = 101). Generalized estimating equation (GEE) logistic regression models were used to examine the association between cannabis and alcohol co-use and CAS at the sexual event while controlling for study site, condition, adherence to antiretroviral therapy, sex-related alcohol expectancies, and partner type. Participants provided data for 1052 sexual activity days, 60.7% of which involved CAS. Of 638 CAS days, 9.1% involved no substances, 72.0% involved either cannabis or alcohol use, and 18.9% involved cannabis and alcohol co-use. Results indicated that the odds of engaging in CAS were higher for sexual events in which cannabis and alcohol co-use occurred (aOR 2.98; 95% CI 1.27, 6.97) compared to events in which no substance use occurred (p = 0.012), but this relationship was no longer significant when cannabis and alcohol co-use was compared to single substance use (aOR 1.57; 95% CI 0.85, 2.90; p = 0.15). Future research should identify specific substance use (e.g., quantity) and partner characteristics (e.g., level of intoxication) that may uniquely influence the relationship between cannabis and alcohol co-use and condomless sex.
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Cunningham CO, Starrels JL, Zhang C, Bachhuber MA, Sohler NL, Levin FR, Minami H, Slawek DE, Arnsten JH. Medical Marijuana and Opioids (MEMO) Study: protocol of a longitudinal cohort study to examine if medical cannabis reduces opioid use among adults with chronic pain. BMJ Open 2020; 10:e043400. [PMID: 33376181 PMCID: PMC7778768 DOI: 10.1136/bmjopen-2020-043400] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
Abstract
INTRODUCTION In the USA, opioid analgesic use and overdoses have increased dramatically. One rapidly expanding strategy to manage chronic pain in the context of this epidemic is medical cannabis. Cannabis has analgesic effects, but it also has potential adverse effects. Further, its impact on opioid analgesic use is not well studied. Managing pain in people living with HIV is particularly challenging, given the high prevalence of opioid analgesic and cannabis use. This study's overarching goal is to understand how medical cannabis use affects opioid analgesic use, with attention to Δ9-tetrahydrocannabinol and cannabidiol content, HIV outcomes and adverse events. METHODS AND ANALYSES We are conducting a cohort study of 250 adults with and without HIV infection with (a) severe or chronic pain, (b) current opioid use and (c) who are newly certified for medical cannabis in New York. Over 18 months, we collect data via in-person visits every 3 months and web-based questionnaires every 2 weeks. Data sources include: questionnaires; medical, pharmacy and Prescription Monitoring Program records; urine and blood samples; and physical function tests. Using marginal structural models and comparisons within participants' 2-week time periods (unit of analysis), we will examine how medical cannabis use (primary exposure) affects (1) opioid analgesic use (primary outcome), (2) HIV outcomes (HIV viral load, CD4 count, antiretroviral adherence, HIV risk behaviours) and (3) adverse events (cannabis use disorder, illicit drug use, diversion, overdose/deaths, accidents/injuries, acute care utilisation). ETHICS AND DISSEMINATION This study is approved by the Montefiore Medical Center/Albert Einstein College of Medicine institutional review board. Findings will be disseminated through conferences, peer-reviewed publications and meetings with medical cannabis stakeholders. TRIAL REGISTRATION NUMBER ClinicalTrials.gov Registry (NCT03268551); Pre-results.
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Affiliation(s)
- Chinazo O Cunningham
- Division of General Internal Medicine, Montefiore Health System, Bronx, New York, USA
| | - Joanna L Starrels
- Division of General Internal Medicine, Montefiore Health System, Bronx, New York, USA
| | - Chenshu Zhang
- Division of General Internal Medicine, Montefiore Health System, Bronx, New York, USA
| | - Marcus A Bachhuber
- Section of Community and Population Medicine, Louisiana State University Health Sciences Center, New Orleans, Louisiana, USA
| | - Nancy L Sohler
- School of Medicine, City University of New York, New York, New York, USA
| | - Frances R Levin
- Department of Psychiatry, Columbia University Irving Medical Center, New York, New York, USA
| | - Haruka Minami
- Psychology Department, Fordham University, Bronx, New York, USA
| | - Deepika E Slawek
- Division of General Internal Medicine, Montefiore Health System, Bronx, New York, USA
| | - Julia H Arnsten
- Division of General Internal Medicine, Montefiore Health System, Bronx, New York, USA
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Alon L, Bruce D, Blocker O, Bouris AM, Reirden DH, Schneider JA. Perceptions of quality and safety in cannabis acquisition amongst young gay and bisexual men living with HIV/AIDS who use cannabis: Impact of legalisation and dispensaries. THE INTERNATIONAL JOURNAL OF DRUG POLICY 2020; 88:103035. [PMID: 33310342 DOI: 10.1016/j.drugpo.2020.103035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2020] [Revised: 10/13/2020] [Accepted: 10/30/2020] [Indexed: 10/22/2022]
Abstract
BACKGROUND Upwards of 35% of young gay and bisexual men living with HIV report daily use of cannabis in the U.S. The effects of legalisation of recreational and medical cannabis on the acquisition of cannabis products amongst a group with such high prevalence of use is largely unknown. METHODS We investigated potential effects of recent legalisation and changes in distribution venues/networks in U.S. jurisdictions (Denver and Chicago) with different legal statuses regarding medical and recreational cannabis. We conducted semi-structured interviews with 30 young gay and bisexual men living with HIV recruited from adolescent HIV clinics and service sites in the two cities. RESULTS Findings indicate four domains in which the acquisition of cannabis from medical or recreational dispensaries was differentiated by participants from acquisition from illicit drug distribution networks: quality of information, perceived quality of products, safety of acquisition, and safety of products. Some participants expressed reservations in becoming involved with requirements for accessing legal distribution of medical and recreational cannabis. CONCLUSIONS Our findings indicate that young men living with HIV in Denver perceive benefits from legalisation of cannabis in terms of quality of information and products and safety of acquisition for a range of medical, therapeutic, and recreational uses. Participants in Chicago report mixed levels of knowledge of potential benefits through the medical cannabis dispensaries in their area, and continue to be exposed to safety risks associated with street-based acquisition. Concerns regarding institutional involvement in medical cannabis registries and dispensaries may inhibit the uptake of legal means of acquisition in sub-populations of young men living with HIV.
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Affiliation(s)
- Leigh Alon
- Chicago Center for HIV Elimination, University of Chicago, 1525 E 55th st, Chicago, IL, 60615, United States.
| | - Douglas Bruce
- Department of Health Sciences, DePaul University, 1110W. Belden Ave., Chicago, IL, 60614, United States
| | - Olivia Blocker
- Chicago Center for HIV Elimination, University of Chicago, 1525 E 55th st, Chicago, IL, 60615, United States; School of Social Service Administration, University of Chicago, 969 E 60th st Chicago, IL, 60637, United States
| | - Alida M Bouris
- Chicago Center for HIV Elimination, University of Chicago, 1525 E 55th st, Chicago, IL, 60615, United States; School of Social Service Administration, University of Chicago, 969 E 60th st Chicago, IL, 60637, United States
| | - Daniel H Reirden
- Children's Hospital Colorado, University of Colorado School of Medicine, 13123 E 16th Ave, Aurora, CO, 80045, United States
| | - John A Schneider
- Chicago Center for HIV Elimination, University of Chicago, 1525 E 55th st, Chicago, IL, 60615, United States; Department of Medicine, University of Chicago, 5841 S Maryland Ave, Chicago, IL, 60637, United States; Department of Public Health Sciences, University of Chicago, 5841 S Maryland Ave Chicago, IL, 60637, United States
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Predictors of Condomless Anal Intercourse in Young HIV-Positive Men Who Have Sex With Men With Detectable Viral Loads. J Adolesc Health 2020; 66:672-683. [PMID: 31987721 PMCID: PMC7263982 DOI: 10.1016/j.jadohealth.2019.12.006] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/13/2019] [Revised: 12/07/2019] [Accepted: 12/10/2019] [Indexed: 01/29/2023]
Abstract
PURPOSE A minority of young, gay, bisexual, and other men who have sex with men (YGBMSM) living with HIV in the U.S. achieve viral suppression, thus increasing the likelihood of viral transmission during condomless anal intercourse (CAI). The purpose of this study was to explore potential risk factors for CAI and serodiscordant CAI (SD-CAI) among YGBMSM with detectable viremia. METHODS A total of 146 YGBMSM (aged 16-24 years) with a detectable viremia enrolled in a mobile health adherence intervention. Baseline characteristics, stratified by any CAI and any SD-CAI (past 3 months), were computed. Random Forests and regression methods were used to assess factors associated with each type of CAI. Adjusted prevalence rate ratios (aPRR) and 95% confidence intervals (CIs) were calculated. RESULTS Half (51.9%) reported engaging in CAI; 57.1% of those reported SD-CAI. There was strong agreement between the Random Forests and regression methods. Significant risk factors of CAI included marijuana use (aPRR = 1.97, 95% CI: 1.21-3.21), problematic substance use (aPRR = 1.56, 95% CI: 1.11-2.20), and being in a committed relationship (aPRR = 1.66, 95% CI: 1.21-2.27). Only 47% believed they were less likely to transmit HIV through CAI when virally suppressed. CONCLUSION High rates of CAI, including engagement in SD-CAI in a population of YGBMSM with detectable viral loads, pose significant concerns for onward transmission. Individual, dyadic, and structural predictors of CAI were associated with engagement in risk in this priority population. Addressing these factors in concert with ensuring viral suppression will be key to ending the epidemic among youth.
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Bruce D, Bouris AM, Bowers S, Blocker O, Lee SY, Glidden MF, Schneider JA, Reirden DH. Medical, therapeutic, and recreational use of cannabis among young men who have sex with men living with HIV. ADDICTION RESEARCH & THEORY 2019; 28:250-259. [PMID: 32952491 PMCID: PMC7500448 DOI: 10.1080/16066359.2019.1629427] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/03/2019] [Revised: 06/03/2019] [Accepted: 06/05/2019] [Indexed: 06/11/2023]
Abstract
Cannabis plays a role in symptoms management in HIV, especially the alleviation of pain and nausea and stimulation of appetite, and prevalence of cannabis use in HIV-positive populations exceeds that of the general U.S. population. Previous research has described an "overlap" between medical and recreational cannabis use among persons living with HIV. To understand better the motives associated cannabis use among young men who have sex with men living with HIV (HIV+ YMSM), we conducted semi-structured interviews with 30 HIV+YMSM in Denver and Chicago. Interviews were audio-recorded, transcribed, and coded by a diverse team of analysts. In addition to findings that mapped onto previously identified medical motives and recreational motives, we identified several themes that straddled medical and recreational use in a domain we describe as therapeutic. Themes identified in this therapeutic domain of cannabis use include (a) enhanced introspection among individuals that promotes psychological adjustment to an HIV diagnosis, improved medical management, and future orientation; (b) reflection processes that mitigate interpersonal conflict and improve interpersonal communication; and (c) a social-therapeutic phenomena of cannabis use among young persons with living HIV that is characterized by both enhanced introspection and improved interpersonal communication. Our findings suggest a spectrum of cannabis use among HIV+ YMSM that may be characterized not only by an overlap between medical and recreational use, but also by a distinct therapeutic domain that incorporates stress alleviation and cognitive expansion processes to improve focus on HIV management and self-care.
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Affiliation(s)
- Douglas Bruce
- Department of Health Sciences, DePaul University, Chicago, IL
| | - Alida M. Bouris
- School of Social Service Administration, University of Chicago, Chicago, IL
- Chicago Center for HIV Elimination, University of Chicago, Chicago, IL
| | - Shannon Bowers
- Department of Health Sciences, DePaul University, Chicago, IL
| | - Olivia Blocker
- School of Social Service Administration, University of Chicago, Chicago, IL
- Chicago Center for HIV Elimination, University of Chicago, Chicago, IL
| | - Soo Young Lee
- School of Social Service Administration, University of Chicago, Chicago, IL
- Chicago Center for HIV Elimination, University of Chicago, Chicago, IL
| | - Mary F. Glidden
- Children’s Hospital Colorado, University of Colorado School of Medicine, Aurora, CO
| | - John A. Schneider
- Chicago Center for HIV Elimination, University of Chicago, Chicago, IL
- Department of Medicine, University of Chicago, Chicago, IL
- Department of Public Health Sciences, University of Chicago, Chicago, IL
| | - Daniel H. Reirden
- Children’s Hospital Colorado, University of Colorado School of Medicine, Aurora, CO
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Chou FY, Armstrong HL, Wang L, Bacani N, Lachowsky NJ, Patterson TL, Walsh Z, Olarewaju G, Card KG, Roth EA, Hogg RS, Moore DM. A longitudinal analysis of cannabis use and mental health symptoms among gay, bisexual, and other men who have sex with men in Vancouver, Canada. J Affect Disord 2019; 247:125-133. [PMID: 30665075 PMCID: PMC6588188 DOI: 10.1016/j.jad.2019.01.015] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/29/2018] [Revised: 01/03/2019] [Accepted: 01/13/2019] [Indexed: 01/04/2023]
Abstract
BACKGROUND Cannabis use, anxiety, and depression are common among gay, bisexual, and other men who have sex with men (gbMSM) and some report using cannabis to manage mental health symptoms. METHODS Sexually-active gbMSM aged ≥16 years were recruited into a longitudinal cohort through respondent-driven sampling and completed study visits every six months. Data on demographics, drug use, and anxiety and depression symptoms were collected via a self-administered computer-based survey. A study nurse determined previous mental health diagnoses and treatment. Using multivariable generalized linear mixed models, we examined factors associated with regular cannabis use (≥weekly in the previous 3 months) and, among individuals who reported anxiety or depression/bipolar diagnoses, factors associated with moderate/severe anxiety or depression symptoms. RESULTS Of 774 participants (551 HIV-negative, 223 HIV-seropositive), 250 (32.3%) reported regular cannabis use, 200 (26.4%) reported ever being diagnosed with anxiety, and 299 (39.3%) reported ever being diagnosed with depression or bipolar disorder at baseline. Regular cannabis use was positively associated with HIV-seropositivity (aOR = 2.23, 95%CI:1.40-3.54) and previous mental health diagnosis (aOR = 1.52, 95%CI: 1.00-2.31, p = 0.05). Among those previously diagnosed with anxiety or depression/bipolar disorder, regular cannabis use was not associated with moderate/severe anxiety (aOR = 1.16, 95%CI:0.69-1.94) or depression symptoms (aOR = 0.96, 95%CI:0.59-1.58), respectively. LIMITATIONS Because of observational study design, we are unable to determine absolute effect. CONCLUSIONS Regular cannabis use was more likely among HIV-positive gbMSM and those previously diagnosed with a mental health disorder. No association was found between regular cannabis use and severity of anxious or depressive symptoms among those diagnosed with these conditions.
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Affiliation(s)
- Frank Y Chou
- BC Centre for Excellence in HIV/AIDS, 608-1081 Burrard Street, Vancouver, BC V6Z 1Y6, Canada; Queen's University, Kingston, Ontario, Canada
| | - Heather L Armstrong
- BC Centre for Excellence in HIV/AIDS, 608-1081 Burrard Street, Vancouver, BC V6Z 1Y6, Canada; Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada.
| | - Lu Wang
- BC Centre for Excellence in HIV/AIDS, 608-1081 Burrard Street, Vancouver, BC V6Z 1Y6, Canada
| | - Nicanor Bacani
- BC Centre for Excellence in HIV/AIDS, 608-1081 Burrard Street, Vancouver, BC V6Z 1Y6, Canada
| | - Nathan J Lachowsky
- BC Centre for Excellence in HIV/AIDS, 608-1081 Burrard Street, Vancouver, BC V6Z 1Y6, Canada; University of Victoria, Victoria, BC, Canada
| | | | - Zach Walsh
- Department of Psychology, University of British Columbia, Kelowna, BC, Canada
| | - Gbolahan Olarewaju
- BC Centre for Excellence in HIV/AIDS, 608-1081 Burrard Street, Vancouver, BC V6Z 1Y6, Canada
| | - Kiffer G Card
- BC Centre for Excellence in HIV/AIDS, 608-1081 Burrard Street, Vancouver, BC V6Z 1Y6, Canada; University of Victoria, Victoria, BC, Canada
| | - Eric A Roth
- University of Victoria, Victoria, BC, Canada
| | - Robert S Hogg
- BC Centre for Excellence in HIV/AIDS, 608-1081 Burrard Street, Vancouver, BC V6Z 1Y6, Canada; Simon Fraser University, Burnaby, BC, Canada
| | - David M Moore
- BC Centre for Excellence in HIV/AIDS, 608-1081 Burrard Street, Vancouver, BC V6Z 1Y6, Canada; Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada
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Lim AC, Thames AD. Differential relationships between cannabis consumption and sleep health as a function of HIV status. Drug Alcohol Depend 2018; 192:233-237. [PMID: 30273891 PMCID: PMC6233990 DOI: 10.1016/j.drugalcdep.2018.07.026] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/05/2018] [Revised: 07/11/2018] [Accepted: 07/14/2018] [Indexed: 11/26/2022]
Abstract
BACKGROUND There is evidence that regular cannabis use has negative effects on sleep health. Relative to HIV- populations, HIV + individuals consistently report greater sleep impairments. The number of HIV + individuals reporting frequent cannabis use, often to treat sleep issues, has significantly increased recently. It is unknown, however, if HIV status moderates the association between cannabis use and sleep health. The current study, therefore, examines these associations in a sample of HIV + and HIV- adults. METHODS HIV + and HIV- (N = 107) individuals completed one laboratory visit. Participants completed a 30-day drug use history questionnaire quantifying consumption of cannabis, cigarettes, and alcohol, and a sleep health questionnaire. To verify substance use and HIV status, participants completed a urine toxicology screening and serology testing. RESULTS HIV + individuals demonstrated lower sleep health than HIV- individuals. Linear regressions indicated that HIV status moderated the association between total 30-day cannabis consumption and sleep health; cannabis consumption was negatively associated with sleep health in HIV-, but not HIV + individuals. This interactive effect was significant after examining cigarette/alcohol use, depression symptoms, and demographic variables as covariates. CONCLUSIONS These results corroborate studies demonstrating an inverse relationship between sleep health and cannabis consumption. This study also suggests that factors other than cannabis may be associated with lower sleep health in HIV + individuals. Emerging studies suggest that inflammation may mediate effects of cannabis on HIV infection. Future studies examining this mechanism are warranted to understand cannabis further and sleep in HIV + individuals.
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Affiliation(s)
- Aaron C. Lim
- Department of Psychology, University of California, Los Angeles, Los Angeles, CA, 90095 USA
| | - April D. Thames
- Department of Psychology, University of Southern California, Los Angeles, CA, 90089 USA
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Gamarel KE, Nichols S, Kahler CW, Westfall AO, Lally MA, Wilson CM. A cross-sectional study examining associations between substance use frequency, problematic use and STIs among youth living with HIV. Sex Transm Infect 2018; 94:304-308. [PMID: 29180537 PMCID: PMC6002747 DOI: 10.1136/sextrans-2017-053334] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2017] [Revised: 10/04/2017] [Accepted: 11/04/2017] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVES This study sought to examine the prevalence of STIs and whether substance use frequency and/or problematic use-specifically alcohol, marijuana and other drugs-was associated with having an STI diagnosis among youth living with HIV (YLWH) METHODS: A sample of 823 YLWH were recruited at 14 adolescent HIV clinics through the Adolescent Medicine Trials Network for HIV Interventions. Study staff abstracted STI data from medical records for up to 26 weeks prior to participants' completing a cross-sectional survey including the ASSIST (Alcohol, Smoking and Substance Involvement Screening Test), which measures substance use frequency and consequences. RESULTS Almost one-third of youth had been diagnosed with an STI (30.5%) at the time of their baseline assessment. In multivariable analyses, those who engaged in weekly or greater marijuana use (adjusted OR (AOR)=10.66, 95% CI: 4.39 to 25.87, P<0.001) had an increased odds of being diagnosed with an STI. Additionally, youth who met alcohol use criteria for moderate (AOR=5.23, 95% CI: 2.50 to 10.93, P<0.001) and high risk (AOR=6.53, 95% CI: 1.20 to 35.68, P<0.05) alcohol use had an increased odds of being diagnosed with an STI compared with low-risk alcohol users. CONCLUSIONS Study findings underscore the need to investigate the role of greater frequency of marijuana use and problematic alcohol use in STI incidence among YLWH. Given the associations between both substance use frequency and problematic use in STI diagnoses among YLWH seen in HIV care settings, clinicians should use validated substance use screening tools which capture both frequencies and consequences in order to identify YLWH who may need further evaluation and treatment.
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Affiliation(s)
- Kristi E. Gamarel
- Department of Health Behavior and Health Education, University of Michigan School of Public Health, Ann Arbor, MI USA
| | - Sharon Nichols
- Department of Medicine, University of California, San Diego, CA USA
| | - Christopher W. Kahler
- Center for Alcohol & Addiction Studies and Department of Behavioral and Social Science, Brown University School of Public Health, Providence, RI USA
| | | | - Michelle A. Lally
- Lifespan Hospital System, Providence, RI USA
- Alpert Medical School, Brown University, Providence, RI USA
| | - Craig M. Wilson
- Department of Epidemiology, University of Alabama at Birmingham, USA
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Memory Impairment in HIV-Infected Individuals with Early and Late Initiation of Regular Marijuana Use. AIDS Behav 2018; 22:1596-1605. [PMID: 28884250 DOI: 10.1007/s10461-017-1898-z] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
Marijuana use is disproportionately prevalent among HIV-infected individuals. The strongest neurocognitive effect of marijuana use is impairment in the domain of memory. Memory impairment is also high among HIV-infected persons. The present study examined 69 HIV-infected individuals who were stratified by age of regular marijuana initiation to investigate how marijuana use impacts neurocognitive functioning. A comprehensive battery assessed substance use and neurocognitive functioning. Findings indicated early onset marijuana users (regular use prior to age 18), compared to non-marijuana users and late onset marijuana users (regular use at age 18 or later), were over 8 times more likely to have learning impairment and nearly 4 times more likely to have memory impairment. A similar pattern of early onset marijuana users performing worse in learning emerged when examining domain deficit scores. The potential for early onset of regular marijuana use to exacerbate already high levels of memory impairment among HIV-infected persons has important clinical implications, including increased potential for medication non-adherence and difficulty with independent living.
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Adams JW, Bryant KJ, Edelman EJ, Fiellin DA, Gaither JR, Gordon AJ, Gordon KS, Kraemer KL, Mimiaga MJ, Operario D, Tate JP, van den Berg JJ, Justice AC, Marshall BDL. Association of Cannabis, Stimulant, and Alcohol use with Mortality Prognosis Among HIV-Infected Men. AIDS Behav 2018; 22:1341-1351. [PMID: 28887669 DOI: 10.1007/s10461-017-1905-4] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
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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Affiliation(s)
- Joëlla W Adams
- Brown University School of Public Health, Providence, RI, USA
| | - Kendall J Bryant
- National Institute on Alcohol Abuse and Alcoholism, National Institutes of Health, Rockville, MD, USA
| | - E Jennifer Edelman
- Division of General Internal Medicine and the Center for Interdisciplinary Research on AIDS, Yale University School of Medicine, New Haven, CT, USA
| | - David A Fiellin
- Division of General Internal Medicine and the Center for Interdisciplinary Research on AIDS, Yale University School of Medicine, New Haven, CT, USA
| | - Julie R Gaither
- Department of Epidemiology of Microbial Diseases, Yale School of Public Health, Yale University, New Haven, CT, USA
| | - Adam J Gordon
- Center for Health Equity Research and Promotion, Pittsburgh VA Healthcare System, Pittsburgh, PA, USA
- Division of General Internal Medicine, Department of Medicine, Center for Research on Health Care, University of Pittsburgh, Pittsburgh, PA, USA
| | - Kirsha S Gordon
- Veterans Aging Cohort Study Coordinating Center, Veterans Administration Connecticut Healthcare System, West Haven, CT, USA
| | | | | | - Don Operario
- Brown University School of Public Health, Providence, RI, USA
| | - Janet P Tate
- Division of General Internal Medicine and the Center for Interdisciplinary Research on AIDS, Yale University School of Medicine, New Haven, CT, USA
- Veterans Aging Cohort Study Coordinating Center, Veterans Administration Connecticut Healthcare System, West Haven, CT, USA
| | | | - Amy C Justice
- Division of General Internal Medicine and the Center for Interdisciplinary Research on AIDS, Yale University School of Medicine, New Haven, CT, USA
- Veterans Aging Cohort Study Coordinating Center, Veterans Administration Connecticut Healthcare System, West Haven, CT, USA
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Okafor CN, Cook RL, Chen X, Surkan PJ, Becker JT, Shoptaw S, Martin E, Plankey MW. Prevalence and correlates of marijuana use among HIV-seropositive and seronegative men in the Multicenter AIDS Cohort Study (MACS), 1984-2013. THE AMERICAN JOURNAL OF DRUG AND ALCOHOL ABUSE 2017; 43:556-566. [PMID: 27808576 PMCID: PMC5415427 DOI: 10.1080/00952990.2016.1245738] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/06/2016] [Revised: 10/04/2016] [Accepted: 10/04/2016] [Indexed: 10/20/2022]
Abstract
BACKGROUND Marijuana use is common among HIV+ individuals, but few studies have examined long-term trends in prevalence and correlates of use. METHODS We evaluated trends (1984-2013) in the annual prevalence of current (past 6-month use) and daily (among current users) marijuana use and determined correlates of use among 2742 HIV-seropositive (HIV+) and 3172 HIV-seronegative (HIV-) men who have sex with men in the Multicenter AIDS Cohort Study (MACS). Poisson regression models were used to estimate prevalence ratios of marijuana use separately for the men who were enrolled before 2001 (early-cohort) and after 2001 (late-cohort). RESULTS Over the 29 years of the study, the prevalence of current marijuana use declined significantly, whereas daily use among users increased among all men in the early and late-cohorts. A HIV+ status was associated with higher prevalence of marijuana use among the men in the early-cohort (adjusted prevalence ratio [aPR] = 1.53, 95% confidence interval [CI]:1.42, 1.64, p = <0.0001), but not in the men in the late-cohort (aPR = 0.90, 95% CI: 0.79, 1.03, p = 0.1424). Alcohol use and cigarette smoking were being positively associated with marijuana use. CONCLUSIONS Although the annual prevalence of current marijuana use decreased significantly over time in the MACS, daily use among users increased significantly. Further, among the HIV+ men, our study did not show clinically significant adverse effects of marijuana use on highly active antiretroviral therapy use, CD4+ count, or HIV viral load.
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Affiliation(s)
- Chukwuemeka N Okafor
- a Department of Epidemiology, College of Public Health and Health Professions, College of Medicine , University of Florida , Gainesville , FL , USA
| | - Robert L Cook
- a Department of Epidemiology, College of Public Health and Health Professions, College of Medicine , University of Florida , Gainesville , FL , USA
| | - Xinguang Chen
- a Department of Epidemiology, College of Public Health and Health Professions, College of Medicine , University of Florida , Gainesville , FL , USA
| | - Pamela J Surkan
- b Social and Behavioral Interventions Program, Department of International Health , Johns Hopkins Bloomberg School of Public Health , Baltimore , MD , USA
| | - James T Becker
- c Departments of Psychiatry, Neurology and Psychology , University of Pittsburgh , Pittsburgh , PA , USA
| | - Steve Shoptaw
- d David Geffen School of Medicine , Department of Family Medicine at University of California , Los Angeles , USA
| | - Eileen Martin
- e Department of Psychiatry , Rush University Medical Center , Chicago , IL USA
| | - Michael W Plankey
- f Georgetown University Medical Center , Department of Medicine, Division of Infectious Diseases , Washington , DC , USA
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14
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Trajectories of Marijuana Use among HIV-seropositive and HIV-seronegative MSM in the Multicenter AIDS Cohort Study (MACS), 1984-2013. AIDS Behav 2017; 21:1091-1104. [PMID: 27260179 DOI: 10.1007/s10461-016-1445-3] [Citation(s) in RCA: 31] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
To construct longitudinal trajectories of marijuana use in a sample of men who have sex with men living with or at-risk for HIV infection. We determined factors associated with distinct trajectories of use as well as those that serve to modify the course of the trajectory. Data were from 3658 [1439 HIV-seropositive (HIV+) and 2219 HIV-seronegative (HIV-)] participants of the Multicenter AIDS Cohort Study. Frequency of marijuana use was obtained semiannually over a 29-year period (1984-2013). Group-based trajectory models were used to identify the trajectories and to determine predictors and modifiers of the trajectories over time. Four distinct trajectories of marijuana use were identified: abstainer/infrequent (65 %), decreaser (13 %), increaser (12 %) and chronic high (10 %) use groups. HIV+ status was significantly associated with increased odds of membership in the decreaser, increaser and chronic high use groups. Alcohol, smoking, stimulant and other recreational drug use were associated with increasing marijuana use across all four trajectory groups. Antiretroviral therapy use over time was associated with decreasing marijuana use in the abstainer/infrequent and increaser trajectory groups. Having a detectable HIV viral load was associated with increasing marijuana use in the increaser group only. Future investigations are needed to determine whether long-term patterns of use are associated with adverse consequences especially among HIV+ persons.
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15
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Smiley SL, Elmasry H, Webb Hooper M, Niaura RS, Hamilton AB, Milburn NG. Feasibility of Ecological Momentary Assessment of Daily Sexting and Substance Use Among Young Adult African American Gay and Bisexual Men: A Pilot Study. JMIR Res Protoc 2017; 6:e9. [PMID: 28153816 PMCID: PMC5314099 DOI: 10.2196/resprot.6520] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2016] [Revised: 11/30/2016] [Accepted: 12/13/2016] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Recent evidence suggests that sexualized text communication ("sexting") is associated with substance use and sexual risk behaviors among young adults, yet little is known about this relationship among young adult African American gay and bisexual men, a population disproportionately impacted by HIV in the United States. Rapid advances in mobile phone technology indicate a clear need for research using mobile health (mHealth) methods such as ecological momentary assessment (EMA) to serve as a viable counterpart to retrospective evaluation methods by using real-time data collection to assess sexting and substance use among this population. OBJECTIVE The objective of this pilot study was to (1) describe the EMA study design and protocol, (2) characterize the study population, and (3) assess the feasibility of a random prompt text message-based thrice-daily EMA over 14 days, as a means of prospectively studying sexting, marijuana, and alcohol use among a sample of young adult African American gay and bisexual men ages 21 to 25. METHODS Participants were recruited through flyers and snowball sampling during spring and summer 2015 at a community-based HIV/AIDS prevention, care, and support organization in Washington, DC. Eligible participants were enrolled in a one-time in-person study visit that consisted of informed written consent to participate in the study, a self-administered survey, a semi-structured interview, and enrollment and training in EMA data collection. Commencing the day after the study visit, a random prompt survey was texted to participants on their personal mobile phones 3 times a day over a 14-day data collection period assessing mood, texts sent, texts received, sexts sent, sexts received, marijuana want, marijuana use, and alcohol use. RESULTS EMA feasibility was tested with 25 self-identified African American gay (n=16) and bisexual (n=9) men (mean age of 23.48 years, SD 1.5). Each random prompt survey had 8 questions with responses including yes/no and Likert scale options. There were 104 total days of EMA observation, and the retention rate was 72% (18 out of 25 participants). Participants responded to the random prompt surveys with a 57.3% compliance rate providing a total of 544 completed surveys out of 949 surveys. The overall mean response time to complete a survey was 6.1 minutes. There were significant positive associations between EMA texts sent and received questions (ρ 0.84, P<.001) as well as sexts sent and received queries (ρ 0.72, P<.001). CONCLUSIONS The use of an EMA protocol has the potential to be a very useful research tool for understanding episodic behaviors such as sexting and substance use in this relatively understudied and underserved population, and has implications for practice. Additional research is needed on how to maximize survey compliance.
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Affiliation(s)
- Sabrina L Smiley
- Schroeder Institute for Tobacco Research and Policy Studies at Truth Initiative, Washington, DC, United States
| | - Hoda Elmasry
- Schroeder Institute for Tobacco Research and Policy Studies at Truth Initiative, Washington, DC, United States
| | - Monica Webb Hooper
- Case Comprehensive Cancer Center, School of Medicine, Case Western Reserve University, Cleveland, OH, United States
| | - Raymond S Niaura
- Schroeder Institute for Tobacco Research and Policy Studies at Truth Initiative, Washington, DC, United States.,Department of Health, Behavior, and Society, Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, United States.,Georgetown University Medical Center, Lombardi Comprehensive Cancer Center, Georgetown University, Washington, DC, United States
| | - Alison B Hamilton
- Department of Psychiatry and Biobehavioral Sciences, Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, Los Angeles, CA, United States.,Veterans Administration Greater Los Angeles Healthcare System, Veterans Administration Center for the Study of Healthcare Innovation, Implementation, and Policy, Los Angeles, CA, United States
| | - Norweeta G Milburn
- Department of Psychiatry and Biobehavioral Sciences, Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, Los Angeles, CA, United States
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16
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Bruce D, Kahana SY, Bauermeister JA, Nichols SL, Hightow-Weidman LB, Heinze JE, Shea J, Fernández MI. Neighborhood-level and individual-level correlates of cannabis use among young persons living with HIV/AIDS. Drug Alcohol Depend 2015; 151:173-80. [PMID: 25858786 PMCID: PMC4447557 DOI: 10.1016/j.drugalcdep.2015.03.017] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/15/2014] [Revised: 03/03/2015] [Accepted: 03/17/2015] [Indexed: 12/27/2022]
Abstract
INTRODUCTION In addition to individual characteristics, there may be a wide range of environmental or neighborhood stressors that contribute to elevated cannabis use in groups of youth living with HIV/AIDS (YLHIV); however, the effects of social disorganization on cannabis use in YLHIV to date have not been studied. METHODS We examined the effects of individual-level and neighborhood-level factors by developing hierarchical generalized linear models estimating odds of current cannabis use (any use during the past 3 months) and daily cannabis use among a sample of YLHIV (N = 1921) currently receiving medical care. RESULTS The final model for daily cannabis use in the past 3 months included significant positive effects associated with hostility (O.R. = 1.08, 95% C.I.: 1.05, 1.11), being older (O.R. = 1.12, 95% C.I.: 1.05, 1.20), being a bisexual male (O.R. = 1.72, 95% C.I.: 1.10, 2.70), and residing in a community with a murder rate in the highest quartile (O.R. = 1.91, 95% C.I.: 1.27, 2.87), second highest quartile (O.R. = 1.62, 95% C.I.: 1.06, 2.46), or third highest quartile (O.R. = 1.52, 95% C.I.: 1.01, 2.30). DISCUSSION This paper advances our knowledge of the multilevel factors associated with elevated cannabis use among groups of YLHIV and furthers our understanding of social and structural determinants of health in this population. Future research into cannabis use among YLHIV should consider, not only cannabis use within the context of the adjustment of living with HIV/AIDS, but also the stressors that characterize the environments in which groups of YLHIV live.
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Affiliation(s)
- Douglas Bruce
- Department of Health Sciences, DePaul University, Chicago, IL, United States.
| | | | - Jose A. Bauermeister
- Department of Health Behavior and Health Education, School of Public Health, University of Michigan, Ann Arbor, Michigan
| | - Sharon L. Nichols
- Department of Neurosciences, UC San Diego School of Medicine, San Diego, California
| | - Lisa B. Hightow-Weidman
- Division of Infectious Diseases, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, North Carolina
| | - Justin E. Heinze
- Department of Health Behavior and Health Education, School of Public Health, University of Michigan, Ann Arbor, Michigan
| | - Jaclyn Shea
- Department of Health Sciences, DePaul University, Chicago, Illinois
| | - M. Isabel Fernández
- College of Osteopathic Medicine, Nova Southeastern University, Davie, Florida
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Brown LK, Whiteley L, Harper GW, Nichols S, Nieves A. Psychological symptoms among 2032 youth living with HIV: a multisite study. AIDS Patient Care STDS 2015; 29:212-9. [PMID: 25585049 PMCID: PMC4378856 DOI: 10.1089/apc.2014.0113] [Citation(s) in RCA: 40] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023] Open
Abstract
This study determined the prevalence and patterns of psychological symptoms in adolescents and young adults living with HIV (YLWH) in medical care and relationships between psychological symptoms, route and duration of infection, and antiretroviral treatment (ART). A clinic-based sample of 2032 YLWH (mean age 20.3 years), recruited from 20 adolescent medicine HIV clinics, completed a cross-sectional survey of health behaviors and psychological symptoms using the Brief Symptom Inventory (BSI). Overall, 17.5% of youth reported psychological symptoms greater than the normative threshold on the Global Severity Index. A wide variety of symptoms were reported. The prevalence of clinical symptoms was significantly greater in youth with behaviorally acquired HIV compared to those with perinatally acquired infection (20.6% vs. 10.8%, OR=2.06 in Multiple Logistic Regression (MLR)), and in those not taking ART that had been prescribed (29. 2% vs. 18.8%, OR=1.68 in MLR). Knowing one's HIV status for more than one year and disclosure of HIV status were not associated with fewer symptoms. A large proportion of YLWH have psychological symptoms and the prevalence is greatest among those with behaviorally acquired infection. The high rate of psychological symptoms for youth not taking ART that is prescribed is a cause for concern. Symptoms do not appear to be a transient reaction to diagnosis of HIV.
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Affiliation(s)
- Larry K. Brown
- Rhode Island Hospital, Brown University, Providence, Rhode Island
| | - Laura Whiteley
- Rhode Island Hospital, Brown University, Providence, Rhode Island
| | - Gary W. Harper
- Department of Health Behavior and Health Education, University of Michigan School of Public Health, Ann Arbor, Michigan
| | - Sharon Nichols
- Department of Neurosciences, University of California, San Diego, California
| | - Amethys Nieves
- Rhode Island Hospital, Brown University, Providence, Rhode Island
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Halkitis PN, Siconolfi DE, Stults CB, Barton S, Bub K, Kapadia F. Modeling substance use in emerging adult gay, bisexual, and other YMSM across time: the P18 cohort study. Drug Alcohol Depend 2014; 145:209-16. [PMID: 25456332 PMCID: PMC4254590 DOI: 10.1016/j.drugalcdep.2014.10.016] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/11/2014] [Revised: 10/17/2014] [Accepted: 10/18/2014] [Indexed: 11/18/2022]
Abstract
OBJECTIVE To examine patterns of substance use over time in a new generation of emerging adult gay, bisexual, and other young men who have sex with men (YMSM). METHODS Data were drawn from the first four waves of on ongoing prospective cohort study of YMSM who were ages 18 to 19 at baseline and were assessed each 6 months for substance use via calendar based methods. Latent growth curve modeling was utilized to assess changes over time for four drug use categories: alcohol, marijuana, inhalant nitrates, and other drugs (e.g., cocaine, ecstasy) and between groups (race/ethnicity, perceived familial socioeconomic status; SES). RESULTS Use of all substances increased steadily across the follow-up period. White YMSM demonstrated higher levels of alcohol use at the 18-mo follow-up visit compared to other racial/ethnic groups, while rates of change across groups were similar. Marijuana use at 18 months was highest for Hispanics who also indicated the highest rate of change. Finally, YMSM who reported higher perceived SES reported the lowest use and lowest rates of change for other drug use. Controlling for perceived SES, differences in patterns of drug use by race/ethnicity were evident but differences were not as large. CONCLUSIONS Increases in substance use in the emerging adulthood of YMSM indicate the need for structural and behavioral interventions tailored to address substance use in these young men before chronic patterns of use develop. Differences in patterns of drug use across racial/ethnic and SES groups suggest that interventions need to consider person-level differences.
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Affiliation(s)
- Perry N Halkitis
- Center for Health, Identity, Behavior & Prevention Studies, New York University, 726 Broadway Suite 525, New York, NY 10003, United States; Global Institute of Public Heath, New York University, New York, NY 10003, United States; Department of Population Health, Langone School of Medicine, New York University, New York, NY 10003, United States.
| | - Daniel E Siconolfi
- Department of Health Behavior & Society, John Hopkins Bloomberg School of Public Health, Baltimore, MD, United States
| | - Christopher B Stults
- Center for Health, Identity, Behavior & Prevention Studies, New York University, 726 Broadway Suite 525, New York, NY 10003, United States
| | - Staci Barton
- Center for Health, Identity, Behavior & Prevention Studies, New York University, 726 Broadway Suite 525, New York, NY 10003, United States
| | - Kristen Bub
- College of Education, University of Illinois at Urban-Champaign, Champaign, IL, United States
| | - Farzana Kapadia
- Center for Health, Identity, Behavior & Prevention Studies, New York University, 726 Broadway Suite 525, New York, NY 10003, United States; Global Institute of Public Heath, New York University, New York, NY 10003, United States; Department of Population Health, Langone School of Medicine, New York University, New York, NY 10003, United States
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Scott-Sheldon LAJ, Walstrom P, Carey KB, Johnson BT, Carey MP. Alcohol use and sexual risk behaviors among individuals infected with HIV: a systematic review and meta-analysis 2012 to early 2013. Curr HIV/AIDS Rep 2014; 10:314-23. [PMID: 24078370 DOI: 10.1007/s11904-013-0177-5] [Citation(s) in RCA: 72] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
The purpose of this meta-analytic study is to summarize the current science concerning the (a) prevalence of alcohol use, (b) prevalence of sexual risk behaviors, and (c) association between alcohol use and sexual risk behaviors among people livingwithHIV/AIDS (PLWHA). Studies were included if they sampled PLWHA, evaluated both alcohol use and sexual risk behavior (e.g., condom use, multiple partners), and were published between January 1, 2012, and April 1, 2013. Comprehensive electronic database searches located 728 published studies with relevant keywords; 17 studies (k =19 reports) were included. Findings indicate that a substantial proportion of PLWHA use alcohol and engage in sexual risk behaviors. Among PLWHA, alcohol use was significantly associated with unprotected sex (d +=0.23, 95 % CI=0.05, 0.40; k =5). Secondary prevention programs for PLWHA that address alcohol use in the context of sexual behavior are needed.
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