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Research Article
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Published Online: 23 September 2019

Cannabis Consumption in People Living with HIV: Reasons for Use, Secondary Effects, and Opportunities for Health Education

Publication: Cannabis and Cannabinoid Research
Volume 4, Issue Number 3

Abstract

Introduction: Rates of cannabis consumption range from 40% to 74% among people living with HIV (PLWH). Little is known about the reasons for cannabis use, related modes of administration, effectiveness for symptom relief, or undesirable effects in the modern antiretroviral therapy (ART) era. Our aim was to conduct an exploratory study to identify potential areas for further evaluation and intervention.
Materials and Methods: From January to June 2018, health care providers at the Chronic Viral Illness Service in Montreal, Canada, asked their patients about cannabis use during routine visits. Patients reporting cannabis use were invited to complete a 20-min coordinator-administered questionnaire. Questions related to patterns of use, modes of administration, reasons for use, secondary effects, and HIV health-related factors (e.g., adherence to ART).
Results: One hundred and four PLWH reporting cannabis use participated. Median age was 54 years (interquartile range [IQR] 46–59), 13% were female, and 42% were HIV-Hepatitis C co-infected. Median CD4 count was 590 cells/mm3 (IQR 390–821), 95% of participants were on ART, and 88% had suppressed viral loads. Reported cannabis use was more than once daily (32%); daily (25%); weekly (22%); monthly (17%); and rarely (twice to thrice per year; 6%). The majority of participants (97%) smoked dry plant cannabis. Other modes included vaping (12%), capsules (2%), edibles (21%), and oils (12%). Common reasons for cannabis use were for pleasure (68%) and to reduce anxiety (57%), stress (55%), and pain (57%). Many participants found cannabis “quite effective” or “extremely effective” (45%) for symptom relief. Secondary effects included feeling high (74%), increased cough (45%), paranoia (22%), palpitations (20%), and increased anxiety (21%). Over two-thirds of participants indicated that secondary effects were not bothersome at all. Most participants (68%) rarely missed doses of their ART, while 27% missed occasionally (once to twice per month). The most commonly accessed sources of information about cannabis were friends (77%) and the internet (55%).
Conclusion: The most common reasons for cannabis use in our population were for pleasure, followed by reduction of stress/anxiety and symptoms associated with a medical condition. Most smoke cannabis and rate cannabis as quite effective for symptom relief. While many participants experience secondary effects, most are not bothered by these symptoms. Amid widespread changes in the regulatory landscape of recreational cannabis, health care providers should be prepared to answer questions about cannabis.

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Cite this article as: Costiniuk CT, Saneei Z, Salahuddin S, Cox J, Routy J-P, Rueda S, Abdallah SJ, Jensen D, Lebouché B, Brouillette M-J, Klein M, Szabo J, Frenette C, Giannakis A, Jenabian M-A (2019) Cannabis consumption in people living with HIV: reasons for use, secondary effects, and opportunities for health education, Cannabis and Cannabinoid Research 4:3, 204–213, DOI: 10.1089/can.2018.0068.

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cover image Cannabis and Cannabinoid Research
Cannabis and Cannabinoid Research
Volume 4Issue Number 3September 2019
Pages: 204 - 213

History

Published online: 23 September 2019
Published in print: September 2019
Published ahead of print: 14 May 2019

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Cecilia T. Costiniuk* [email protected]
Chronic Viral Illness Service, Division of Infectious Diseases and Research Institute of the McGill University Health Centre, Montreal, Canada.
Zahra Saneei
Chronic Viral Illness Service, Division of Infectious Diseases and Research Institute of the McGill University Health Centre, Montreal, Canada.
Syim Salahuddin
Chronic Viral Illness Service, Division of Infectious Diseases and Research Institute of the McGill University Health Centre, Montreal, Canada.
Department of Biological Sciences, University of Quebec at Montreal (UQAM), Montreal, Canada.
Joseph Cox
Chronic Viral Illness Service, Division of Infectious Diseases and Research Institute of the McGill University Health Centre, Montreal, Canada.
Department of Family Medicine, McGill University, Montreal, Canada.
Jean-Pierre Routy
Chronic Viral Illness Service, Division of Infectious Diseases and Research Institute of the McGill University Health Centre, Montreal, Canada.
Sergio Rueda
Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, Toronto, Canada.
Sara J. Abdallah
Department of Kinesiology and Physical Education, McGill University, Montreal, Canada.
Dennis Jensen
Department of Kinesiology and Physical Education, McGill University, Montreal, Canada.
Bertrand Lebouché
Chronic Viral Illness Service, Division of Infectious Diseases and Research Institute of the McGill University Health Centre, Montreal, Canada.
Department of Family Medicine, McGill University, Montreal, Canada.
Clinical Outcomes Research and Evaluation (CORE), Research Institute of the McGill University Health Centre, Montreal, Canada.
Marie-Josée Brouillette
Chronic Viral Illness Service, Division of Infectious Diseases and Research Institute of the McGill University Health Centre, Montreal, Canada.
Department of Psychiatry, McGill University Health Centre, Montreal, Canada.
Marina Klein
Chronic Viral Illness Service, Division of Infectious Diseases and Research Institute of the McGill University Health Centre, Montreal, Canada.
Jason Szabo
Chronic Viral Illness Service, Division of Infectious Diseases and Research Institute of the McGill University Health Centre, Montreal, Canada.
Charles Frenette
Chronic Viral Illness Service, Division of Infectious Diseases and Research Institute of the McGill University Health Centre, Montreal, Canada.
Andreas Giannakis
Chronic Viral Illness Service, Division of Infectious Diseases and Research Institute of the McGill University Health Centre, Montreal, Canada.
Mohammad-Ali Jenabian
Department of Biological Sciences, University of Quebec at Montreal (UQAM), Montreal, Canada.

Notes

*
Address correspondence to: Cecilia T. Costiniuk MD, MSc, Research Institute of the, McGill University Health Centre, Room EM 2.3226 Royal Victoria Hospital: Glen Site, 1001 Boulevard Decarie, Montreal H4A 3J1, Quebec, Canada [email protected]

Author Disclosure Statement

The authors have received free product from Tilray, Inc. for use in a clinical trial (Canadian HIV Trials Network PT028), but no financial support was received for this or other studies.

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