Among HIV Patients with Nausea, Medicinal Use of Marijuana May Aid Adherence to Antiretroviral Therapy

Adherence to antiretroviral therapy (ART) is essential to successful treatment of HIV infection. Two recent studies reported a negative correlation between marijuana use and adherence to ART. Some patients, however, report that smoking marijuana improves adherence to ART. This study, within a public health care system for HIV/AIDS, therefore sought to identify which subgroups of patients may have differential adherence to ART in association with recent marijuana use.

Results

With a 5% refusal rate, 252 patients completed the interview, 175 (69%) were on ART, and 168 (67%) provided ART adherence data. Forty-one subjects (24%), predominantly whites, used marijuana.

In bivariate analysis, no association between ART adherence and marijuana use was.

Adherence was positively associated with undetectable plasma virus and negatively associated with alcohol and other illicit drug use.

Examining subgroups of patients, among those with nausea, marijuana users were more likely to show an association with adherence than nonusers, while among those without nausea, marijuana use was lower associated with adherence. This relationship was confirmed in multivariate analyses controlling for the interactions between nausea and marijuana use, in which other illicit drug use remained a factor related to nonadherence.

Discussion

Use of marijuana for medicinal purposes remains controversial, and the authors emphasize that in their article they do not advocate its widespread use.

In conclusion, the authors write, “Our observations do suggest, however, that in certain circumstances, specifically when patients are using marijuana to relieve nausea, marijuana is not associated with lower rates of adherence.”

“The data suggest that medicinal use of marijuana may facilitate, rather than impede, ART adherence for patients with nausea, in contrast to the use of other illicit substances, which were associated with lower rates of ART adherence. To demonstrate any causal relationship between marijuana and adherence would require a longitudinal or controlled study.”

01/21/05

Reference
B C de Jong and others. Marijuana Use and Its Association With Adherence to Antiretroviral Therapy Among HIV-Infected Persons With Moderate to Severe Nausea. Journal of Acquired Immune Deficiency Syndromes 38(1): 43-46, January 1, 2005.