Karina Villalba, PhD
University of Central Florida
Co-Authors: Hanzhi Gao1, Lamisha Rogers1, Kayla Hicks1, Sylvie Naar1, Karen MacDonell1, Scott Pickett1, Sharon Nichols2
1Florida State University, 2University of California San Diego
Background: Alcohol and cannabis consumption is common among young people with HIV and may impact treatment outcomes. Extensive research shows that alcohol use is a risk factor for poor adherence to antiretroviral therapy (ART). However, cannabis use has a complex relationship with substance use and ART adherence; some studies suggest it as a harm reduction approach for other substances, while others associate it with ART non-adherence.
Objectives: This study aimed to determine whether cannabis use is associated with lower alcohol consumption and alcohol-related problems and poorer ART adherence. We hypothesized that higher cannabis use is associated with reduced alcohol consumption and predicts poorer ART adherence.
Methods: The longitudinal DEFINE study recruited young people with HIV aged 18 to 29 who consumed alcohol at least once in the past 30 days. A total of 105 participants who completed the baseline questionnaire were included. To assess alcohol and cannabis use, we used the Alcohol, Smoking, and Substance Involvement Screening Test (ASSIST) substance involvement score, which measures the frequency and consequences of alcohol and cannabis use separately. ART adherence was assessed using the self-reported item: “What percentage of your HIV medication have you taken in the past 30 days?”
Results: Findings showed that the mean age of participants was 26.3 years (SD = 2.7), with 44.8% identifying as Black, 33.3% as White, and 21.9% as Other, while 33.3% identified as Hispanic. The majority of participants (87.6%) were assigned male at birth. The mean ASSIST involvement score for alcohol use was reported as low risk, 9.0 (SD = 5.9), and for cannabis use was moderate risk, 9.3 (SD = 7.3). The percentage of ART medication taken in the past 30 days was 90.0% (SD = 16.8). Preliminary analysis shows that the cannabis and alcohol involvement scores were significantly positively correlated (r = 0.306). Both cannabis and alcohol use were significantly negatively correlated with ART adherence (cannabis: r = -0.292, alcohol: r = -0.238). To further examine these relationships, we will be developing regression models to analyze the effects of cannabis and alcohol use on ART adherence while accounting for potential confounding variables.
Conclusion: Preliminary findings suggest that cannabis involvement may be associated with higher alcohol consumption and alcohol-related problems that could negatively impact ART adherence in young people with HIV.