A longitudinal investigation of the association between cannabis use and alcohol use among people living with HIV

Drug Alcohol Depend. 2018 Dec 1;193:7-13. doi: 10.1016/j.drugalcdep.2018.08.026. Epub 2018 Oct 6.


Background: Both cannabis use and alcohol use are elevated among people living with HIV, but few studies have investigated the relationship between cannabis use and alcohol use in this population. This study examined the longitudinal association between cannabis use and alcohol use among people living with HIV and explored the moderating role of medicinal vs. recreational cannabis use.

Method: Participants were cannabis users (N=763) enrolled in the Ontario HIV Treatment Network Cohort Study (67% White, 88% male, 68% gay, median income in the $40,000-$50,000 range). Participants completed assessments of cannabis use, reasons for cannabis use, and alcohol use at baseline and at annual follow-ups (M = 3.42 completed assessments). Multilevel modeling was used to examine between-person and within-person associations between cannabis use and alcohol use over time.

Results: Greater average frequency of cannabis use was associated with greater average alcohol consumption across participants. Participants classified as medicinal cannabis users reported more frequent cannabis use and less alcohol use on average than recreational cannabis users. Further, within-person changes in cannabis use over time were positively associated with corresponding changes in alcohol use for recreational cannabis users but not for medicinal users.

Conclusion: Cannabis use and alcohol use were positively associated over time among people living with HIV, although this association was specific to those using cannabis for recreational reasons. As alcohol use in this population poses significant health risks, more research on the link between cannabis use and alcohol use is needed, particularly in light of recent changes to cannabis regulations.

Keywords: AIDS; AUDIT-C; Co-use; HIV; Marijuana; Medical marijuana.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Alcohol Drinking / epidemiology*
  • Alcohol Drinking / trends
  • Drug Users / psychology
  • Drug Users / statistics & numerical data
  • Female
  • HIV Infections / epidemiology*
  • HIV Infections / psychology*
  • Humans
  • Longitudinal Studies
  • Male
  • Marijuana Smoking / epidemiology*
  • Marijuana Smoking / trends
  • Medical Marijuana
  • Ontario / epidemiology


  • Medical Marijuana