Patterns of Cannabis Use among Women With HIV in the United States

Cannabis legalization in the United States changed cannabis product potency and consumption modalities. Women with HIV are an aging population with prevalent cannabis use twice that of national estimates. Because cannabis use may confer both health benefits and risks, it is important to understand cannabis use patterns among women with HIV. This analysis characterized prevalence, frequencies, and modes (smoking, vaping, eating) of cannabis use among 1,246 women with HIV in the Women's Interagency HIV Study over 18 months (2018-2019). We compared participant characteristics using chi-square tests and Wilcoxon rank-sum tests. We illustrated flow between cannabis use frequency categories with a Sankey diagram. Median participant age was 52 years (interquartile range: 46, 58). 65% of participants identified as Black/African American; 50% had annual household incomes <$12,000. The period prevalence was 27% for any cannabis use and 15% for daily or more use. 50% reported varying use frequencies. Among women using cannabis, 96% reported smoking, 30% consumed edibles, and 18% vaped. Compared with women not using cannabis, greater proportions of women using cannabis reported alcohol (69% vs. 37%, p < 0.01), cigarette (61% vs. 29%, p < 0.01) and other drug use (16% vs. 4%, p < 0.01). Compared to those with no high potency use, a higher proportion of women using high potency products were in a state legalizing cannabis sales. Cannabis use among women with HIV is common and of variable frequency. Future work should characterize patterns of use, product choice motivations, and associated health impacts in the context of aging and HIV.