Self-Reported Cannabis Use and HIV Viral Control among Patients with HIV Engaged in Care: Results from a National Cohort Study

Int J Environ Res Public Health. 2022 May 6;19(9):5649. doi: 10.3390/ijerph19095649.


Background: The association between cannabis use and HIV-1 RNA (viral load) among people with HIV (PWH) engaged in care is unclear. Methods: We used data collected from 2002 to 2018 on PWH receiving antiretroviral therapy (ART) enrolled in the Veterans Aging Cohort Study. Generalized estimating equations were used to estimate associations between self-reported past-year cannabis use and detectable viral load (≥500 copies/mL), with and without adjustment for demographics, other substance use, and adherence. Results: Among 2515 participants, 97% were male, 66% were Black, the mean age was 50 years, and 33% had detectable HIV viral load at the first study visit. In unadjusted analyses, PWH with any past-year cannabis use had 21% higher odds of a detectable viral load than those with no past-year use (OR = 1.21; 95% CI, 1.07-1.37). However, there was no significant association between cannabis use and viral load after adjustment. Conclusions: Among PWH engaged in care and receiving ART, cannabis use is associated with decreased adherence in unadjusted analyses but does not appear to directly impact viral control. Future studies are needed to understand other potential risks and benefits of cannabis use among PWH.

Keywords: HIV; adherence; cannabis; viral load.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Anti-HIV Agents* / therapeutic use
  • Cannabis*
  • Cohort Studies
  • Female
  • HIV Infections* / drug therapy
  • HIV Infections* / epidemiology
  • Humans
  • Male
  • Medication Adherence
  • Middle Aged
  • Self Report
  • Viral Load


  • Anti-HIV Agents

Grant support

This work was supported by the National Institute on Drug Abuse (R01-DA040471) and the National Institute on Alcohol Abuse and Alcoholism (U10-AA013566, U24-AA020794, and U01-AA020790). In addition, Bahji reports research grants from the National Institutes of Health/National Institute on Drug Abuse (NIDA) through the International Collaborative Addiction Medicine Research Fellowship (R25-DA037756) and the Research in Addiction Medicine Scholars Program (R25-DA033211). 1R01 DA047347, 1R01DA045872, NCATS UL1TR003017, New Jersey Health Foundation for Dr. Stephen Crystal. The content is solely the responsibility of the authors and does not necessarily represent the official views of the Veterans Affairs or the National Institutes of Health.