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

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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.

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.

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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.

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Authors and Affiliations

  1. Division of Pediatric Infectious Diseases, Department of Pediatrics, Duke University School of Medicine, 2 Genome Court, DUMC Box 103020, Durham, NC, 27710, USA

    Amelia B. Thompson

  2. Division of Pediatric Infectious Diseases, Department of Pediatrics, Emory University School of Medicine, Atlanta, GA, USA

    Amelia B. Thompson, Jasper Hood & Andres F. Camacho-Gonzalez

  3. Ponce Family and Youth Clinic, Grady Infectious Diseases Program, Grady Health Systems, Atlanta, GA, USA

    Amelia B. Thompson, Jasper Hood, LaTeshia Thomas-Seaton, Sophia A. Hussen & Andres F. Camacho-Gonzalez

  4. Department of Pediatrics, Emory University School of Medicine, Atlanta, GA, USA

    Scott E. Gillespie

  5. Children’s Healthcare of Atlanta, Atlanta, GA, USA

    LaTeshia Thomas-Seaton

  6. Hubert Department of Global Health, Emory University Rollins School of Public Health, Atlanta, GA, USA

    Sophia A. Hussen

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  1. Amelia B. Thompson
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Contributions

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.

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Correspondence to Amelia B. Thompson.

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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.

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Thompson, A.B., Gillespie, S.E., Hood, J. et al. Regular Marijuana Use is Associated with Poor Viral Suppression in HIV-Infected Adolescents and Young Adults. AIDS Behav 22, 1363–1372 (2018). https://doi.org/10.1007/s10461-017-1961-9

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  • DOI: https://doi.org/10.1007/s10461-017-1961-9

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