Cannabis Use and Self-Reported Bothersome Symptoms in People with HIV
The broad health effects of cannabis consumption among people living with HIV remains poorly understood. This study aimed to examine whether cannabis use is associated with a range of physical and mental health symptoms in this population.
The research was conducted within the MASH study (Medications, Alcohol and Substance use in HIV), a large multi-site study enrolling people with HIV from the Swiss HIV Cohort Study, Kaiser Permanente Northern California, and the Veterans Aging Cohort Study across seven US cities.
Over 1’200 participants completed detailed questionnaires about their symptoms and substance use. A key aspect of this study was the comparison between self-reported substance use and cannabis use based on the analysis specific biomarkers in nail clipping. This allowed the researchers to assess the reliability of self-reporting, as well as the association between cannabis use and symptoms.
The results showed that approximately one in four participants had used cannabis recently, whether by self-report, biomarker, or both, and that agreement between the self-reporting and biomarker measures was high. Cannabis use was associated with a greater likelihood of reporting bothersome symptoms across nearly all 20 symptoms assessed, including fatigue, sleep problems, nausea, and gastrointestinal complaints. Most notably, cannabis use was significantly associated with anxiety, depression, and memory difficulties. Those findings were consistent regardless of whether cannabis use was self-reported or biomarker-confirmed.
The authors acknowledge that, given the cross-sectional design of the study, causality cannot be established: it is possible that some participants were using cannabis to manage pre-existing symptoms rather than cannabis causing those symptoms. Nevertheless, the associations with mental health outcomes are a cause for concern and warrant further investigations. The study calls for greater attention to cannabis use in routine HIV care.