University of Florida
Objective: The use of medical marijuana for treating many medical conditions has become widespread in the USA and around the world, even though the legal status of marijuana use varies across the United States. The recreational and medicinal use of cannabis may be increasing among individuals with HIV due to growing reports of its potential to treat and manage symptoms of HIV/AIDS, such as pain. However, the medical benefits of marijuana use in HIV, as well as its harmful effects, continue to be ardently debated. This review identified and evaluated recent studies assessing the association between marijuana use and HIV outcomes.
Methods: Our database search included Web of Science, Embase, PubMed, and the Cochrane library using the following inclusion criteria: English language, USA-based study dated between May 2016 – December 2020, health outcomes relating to marijuana use in HIV, studies focused on cannabis use. We excluded preclinical studies and any abstract-only articles. Studies were categorized based on design and scored based on quality and risk of bias using the ROBINS-I tool for observational studies.
Results: Twenty-eight studies out of 1722 search hits met inclusion criteria, and 22 were observational studies with cohort or cross-sectional designs. Studies examined outcomes on adherence (7 out of 22), viral suppression (10 out of 22), and pain (5 out of 22). The 11 studies that focused on adherence and viral suppression showed no significant positive effect, but only 1 study determined a positive effect on pain. Also, 3 out of 11 studies examining adherence were rated low quality while none were rated moderate or high quality. Some studies revealed a high prevalence use of marijuana among people living with HIV/AIDS (from 31% to 56%), especially in adolescents and young adults.
Conclusion: There is not enough evidence to support marijuana use in improving adherence and viral suppression as an effective treatment option for HIV/AIDS. However, there is limited evidence to support that marijuana is an effective treatment for alleviating pain among HIV/AIDS patients. This review suggests the need for high-quality research measurements in the assessment of marijuana use in HIV.
Co-authors: Amie Goodin1
1University of Florida