Changes in frequency of cannabis use among people with HIV during the COVID-19 pandemic: a multi-methods study to explore the underlying reasons for change

ABSTRACT

Background: People with HIV (PWH) report higher rates of cannabis use than the general population. It is unclear how cannabis use among PWH has been impacted by the COVID-19 pandemic and the implications for the health and wellbeing of PWH.

Objectives: To describe changes in frequency of cannabis use among a sample of PWH during the pandemic, reasons for those changes, and implications of the findings.

Methods: The data are cross-sectional and come from questions asked in a follow-up phone survey administered to a prospective cohort of PWH in Florida between May 2020 and March 2021. Participants who used cannabis were asked about changes in their frequency of cannabis use in a quantitative survey and reasons for changes in a qualitative open-ended question. Qualitative data were analyzed using thematic analysis.

Results: Among 227 PWH (mean age 50, 50% men, 69% Black/African American, 14% Hispanic/Latino), 13% decreased frequency of cannabis, 11% increased frequency, and 76% reported no change. The most common reasons for increasing frequency of cannabis use were reducing anxiety/stress, trying to relax, coping with grief or reducing symptoms of depression, and reducing boredom during the pandemic. Supply or access issues, health concerns, and having already wanted to reduce cannabis use were common reasons for decreased frequency.

Conclusion: Nearly 25% of the sample changed their cannabis use frequency during the pandemic. These findings shed light on the behaviors and motivations of PWH who use cannabis and can inform clinical practice and interventions during public health emergencies and beyond.

KEYWORDS:

• HIV
• cannabis
• COVID-19

Author contribution

C.E.P. conceptualized the paper, created the qualitative codebook, analyzed the data, and wrote the manuscript; D.V. conceptualized the paper and contributed to manuscript preparation; Y.W. conceptualized the paper and contributed to manuscript preparation; K.V. contributed to manuscript preparation; G.E.I. contributed to manuscript preparation; L.C.C. analyzed the data and contributed to manuscript preparation; R.L.C contributed to the study design and manuscript preparation.

Acknowledgments

We would like to thank all the participants and study staff who donated their time to make the MAPLE study possible.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Additional information

Funding

This study is funded by the National Institute on Drug Abuse (R01DA042609 and R01DA042609-04S1). C.E.P. is funded by the National Institute on Alcohol Abuse and Alcoholism (T32AA025877).