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AIDS Behav. 2017 Sep 8. doi: 10.1007/s10461-017-1905-4. [Epub ahead of print]

Association of Cannabis, Stimulant, and Alcohol use with Mortality Prognosis Among HIV-Infected Men.

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Brown University School of Public Health, Providence, RI, USA.
National Institute on Alcohol Abuse and Alcoholism, National Institutes of Health, Rockville, MD, USA.
Division of General Internal Medicine and the Center for Interdisciplinary Research on AIDS, Yale University School of Medicine, New Haven, CT, USA.
Department of Epidemiology of Microbial Diseases, Yale School of Public Health, Yale University, New Haven, CT, USA.
Center for Health Equity Research and Promotion, Pittsburgh VA Healthcare System, Pittsburgh, PA, USA.
Division of General Internal Medicine, Department of Medicine, Center for Research on Health Care, University of Pittsburgh, Pittsburgh, PA, USA.
Veterans Aging Cohort Study Coordinating Center, Veterans Administration Connecticut Healthcare System, West Haven, CT, USA.
VA Pittsburgh Healthcare System, Pittsburgh, PA, USA.
Brown University School of Public Health, Providence, RI, USA.


Questionnaires over a 9-year study period (2002-2010) were used to characterize cannabis, stimulant, and alcohol use among 3099 HIV-infected men participating in the Veterans Aging Cohort Study (VACS) to determine whether use of these substances is associated with changes in the VACS Index, a validated prognostic indicator for all-cause mortality. At baseline, 18% of participants reported no substance use in the past year, 24% lower risk alcohol use only, 18% unhealthy alcohol use only, 15% cannabis use (with or without alcohol), and 24% stimulant use (with or without alcohol or cannabis). In adjusted longitudinal analyses, cannabis use [β = -0.97 (95% CI -1.93, 0.00), p = 0.048] was not associated with mortality risk, while stimulant use [1.08 (0.16, 2.00), p = 0.021] was associated with an increased mortality risk, compared to lower risk alcohol use. Our findings show no evidence of a negative effect of cannabis use on mortality risk, while stimulant use was associated with increased mortality risk among HIV-infected men. Interventions to reduce stimulant use in this patient population may reduce mortality.


Alcohol; Cannabis; Drug use; HIV/AIDS; Men who have sex with men


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