Heavy Marijuana Use Among Gay and Bisexual Male Emerging Adults Living With HIV/AIDS

Abstract

Marijuana use has been documented to be higher among emerging adults than among other age groups in the United States. Persons living with HIV may use marijuana as a method for alleviating symptoms and side effects associated with treatment as well as a coping or mood adjustment strategy. The authors analyzed data from a two-phase mixed methods study of young HIV-positive gay/bisexual men to explore motivations for heavy marijuana use. Phase I consisted of semistructured qualitative interviews with 54 young gay/bisexual HIV-positive men (mean age 21.0 years) conducted at four geographically and demographically diverse sites. Phase II consisted of a computer-assisted quantitative survey administered to 200 young gay/bisexual HIV-positive men (mean age 21.1 years) across 14 clinical sites within the ATN. Phase I participants described marijuana use chiefly within the contexts of responses to initial HIV diagnosis, stress relief, and relaxation, including active and avoidant coping techniques. Phase II results revealed that almost one-quarter (23%) of the sample reported smoking marijuana every day, and another 16% said they smoked at least weekly but not daily. Logistic regression analysis determined significant predictors of at least weekly marijuana use to be using substances to relieve the stress of living with HIV (β = 1.04, p < .01), using substances alone (β = 2.05, p < .01), and using substances to reduce side effects of medication (β = 2.44, p < .01). Heavy marijuana use in our quantitative sample greatly exceeded rates reported in population-based studies of emerging adults and in previous studies of medicinal marijuana among persons living with HIV. These data have implications for self-care strategies among young persons living with HIV and intervention development for this population.

KEYWORDS:

• marijuana
• substance use
• HIV-positive
• gay/bisexual
• adolescents
• emerging adults
• men who have sex with men

ACKNOWLEDGMENTS

We would like to thank the principal investigators and site coordinators at the clinical sites within the ATN who recruited the participants for this study. ATN070 has been scientifically reviewed by the ATN's Behavioral Leadership Group. We would also like to thank individuals from the ATN Data and Operations Center (Westat) including Julie Davidson, MSN, and Jacqueline Loeb, MBA, and individuals from the ATN Coordinating Center at the University of Alabama including Craig Wilson, MD, Cindy Partlow, M.ed, and Marcia Berck, BA. Additionally, we would like to acknowledge the thoughtful input given by participants of our national and local Youth Community Advisory Boards. Finally, our deep gratitude goes to the participants in this study whose thoughtful input and willingness to share their stories made this study possible.

The Adolescent Medicine Trials Network for HIV/AIDS Interventions (ATN) is funded by grants 5 U01 HD 40533 and 5 U01 HD 40474 from the National Institutes of Health through the National Institute of Child Health and Human Development (Bill Kapogiannis, MD) with supplemental funding from the National Institutes of Drug Abuse (Nicolette Borek, PhD) and Mental Health (Susannah Allison, PhD). Additional funding from the National Institute of Mental Health under grant K01 MH 089838 aided in the development of this article.