Journal of
AIDS and HIV Research

  • Abbreviation: J. AIDS HIV Res.
  • Language: English
  • ISSN: 2141-2359
  • DOI: 10.5897/JAHR
  • Start Year: 2009
  • Published Articles: 290

Full Length Research Paper

Changes in marijuana use and associated attitudes and health behaviors among patients in HIV care in the U.S. in the post-legalization era: a qualitative study

Rob Fredericksen
  • Rob Fredericksen
  • Department of Medicine, University of Washington, United States.
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Emma Fitzsimmons
  • Emma Fitzsimmons
  • Department of Medicine, University of Washington, United States.
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Maksim Sigal
  • Maksim Sigal
  • The Fenway Institute/Fenway Health, United States.
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Sarah Dougherty
  • Sarah Dougherty
  • Department of Medicine, University of Alabama at Birmingham, United States.
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John Pearce
  • John Pearce
  • Department of Medicine, University of Washington, United States.
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Minh Powell
  • Minh Powell
  • Department of Medicine, University of Washington, United States.
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John Nguyen
  • John Nguyen
  • Department of Medicine, University of Washington, United States.
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Stephanie Ruderman
  • Stephanie Ruderman
  • Department of Medicine, University of Washington, United States.
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Bridget Whitney
  • Bridget Whitney
  • Department of Medicine, University of Washington, United States.
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Lydia Drumright
  • Lydia Drumright
  • Department of Medicine, University of Washington, United States.
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Jimmy Ma
  • Jimmy Ma
  • Department of Medicine, University of Washington, United States.
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Robin Nance
  • Robin Nance
  • Department of Medicine, University of Washington, United States.
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Sarah Mixson
  • Sarah Mixson
  • Department of Medicine, University of Washington, United States.
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Joseph Delaney
  • Joseph Delaney
  • College of Pharmacy, University of Manitoba, Canada.
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Kenneth Mayer
  • Kenneth Mayer
  • The Fenway Institute/Fenway Health, United States.
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Amanda Willig
  • Amanda Willig
  • Department of Medicine, University of Alabama at Birmingham, United States.
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Heidi Crane
  • Heidi Crane
  • Department of Medicine, University of Washington, United States.
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Andrew Hahn
  • Andrew Hahn
  • Department of Medicine, University of Washington, United States.
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  •  Received: 27 January 2022
  •  Accepted: 09 December 2022
  •  Published: 31 January 2023

Abstract

We sought to understand the impact that state-level marijuana policy changes had on marijuana use behaviors among people with HIV (PWH), including patterns of use (e.g., frequency, modality), access, goals for use, use of other substances, and perceived health effects. We conducted 1:1 interviews at 3 U.S. HIV clinics with PWH aged ≥18 reporting weekly or more marijuana use; 2 clinics were in states that legalized recreational marijuana use. We coded interviews based on sub-topic areas of clinical interest. Among PWH (n=29, 80% cisgender male; mean age=50; 66% non-white), one-third reported increased use of marijuana products since legalization in their state, primarily related to exploring products for therapeutic needs. In legalized states, PWH reported easier product access. The most-cited therapeutic goals for use included relaxation/sleep (66%), appetite stimulation (41%), stress/anxiety relief (31%), and pain relief (28%), among others. Additionally, some reported marijuana helped maintain sobriety from other substances. In legalized settings, increased product diversity and attribute labeling facilitated decision-making, allowing individuals to tailor use to specific goals. Concern over the long-term impact of smoking marijuana was limited to respiratory effects, with no concerns regarding potential cognitive impacts of use, or effects from using edible formulations. Among a sample of PWH who use marijuana, the broad variety and availability of products following legalization increased use for a third of participants from affected states and was consistently described as offering a means for facilitating decision-making for targeted therapeutic use, including as an aid for sleep, anxiety, appetite, and pain, as well as minimization of craving alcohol and ‘harder’ substances. While the short-term benefits of using marijuana were clearly described, concern over long-term health effects was limited.

Key words: Marijuana use, HIV care, health beliefs.