Marijuana Use Among Young Black Men Who Have Sex With Men and the HIV Care Continuum: Findings From the uConnect Cohort

ABSTRACT

Background: Young Black men who have sex with men (YBMSM) are at highest risk for HIV seroconversion in the United States. Successful movement through the HIV care continuum is an important intervention for limiting onwards HIV transmission. Objective: Little data exists on how substances most commonly used by YBMSM, such as marijuana, are related to the HIV continuum, which represents the primary aim of this study. Methods: A cohort of YBMSM (n = 618) was generated through respondent-driven sampling. Frequency of marijuana use and marijuana use as a sex-drug were assessed across the HIV care continuum using weighted logistic regression models. Results: Study participants reported more intermittent marijuana use (n = 254, 56.2%) compared to heavy use (n = 198, 43.8%). Our sample contained 212 (34.3%) HIV seropositive participants of which 52 (24.5%) were unaware of their HIV positive status. Study participants who were heavy marijuana users were more likely to be unaware of their HIV seropositive status (AOR: 4.18; 95% CI 1.26, 13.89). All other stages in the care continuum demonstrated no significant differences between those who use marijuana intermittently or heavily or as a sex-drug and nonusers. Conclusions: YBMSM who used marijuana heavily were more likely to be HIV-positive unaware than those who never used marijuana. Findings were inconclusive regarding the relationships between marijuana use and other HIV care continuum metrics. However, knowledge of ones’ HIV status is a critical requirement for engaging in care and may have implications for onwards HIV transmission.

KEYWORDS:

• HIV
• marijuana
• HIV care continuum
• substance use
• adherence
• retention
• viral suppression

Acknowledgments

This article is partially based on the following conference poster presentation: Morgan E, Schneider JA, Michaels S, Skaathun B, Young L, Coombs RW, Schumm P, Voisin D, and Friedman S. UConnect Study Team. Marijuana Use and Its Nuanced Relationship With HIV Treatment Continuum Metrics. CROI Conference on Retroviruses and Opportunistic Infections February 2015. Abstract 1006.

We would like to thank all study participants for the time and effort required to recruit their network members and take part in the interview. We would also like to thank Joan Dragavon, Socorro Harb, Audrey Wong, Jose Ortega, Eleanor Espinosa, Carol Gallardo, Corey Scherrer, and Glenda Daza for laboratory technical support. The uConnect study team is: Ishida Robinson, Eve Zurawski, Elc Estrera, Billy Davis, Kenneth Mayer, Ron Stall, Samuel R Friedman, Steve Muth, Michelle Taylor, Iman Little, Keith Green, Billy Davis, and David Pitrak.

Declaration of interest

The authors report no conflicts of interest. The authors alone are responsible for the content and writing of the article.

Funding

This work was supported by NIH grants R21MH098768, R01DA033875, and R01DA039934; the dried blood spot assay development and validation by P30_AI-027757 and UM1-AI-68636 and -06701.