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    Area of Science:

    • Public Health
    • Epidemiology
    • Addiction Medicine

    Background:

    • The aging population in the United States is increasingly using cannabis.
    • People living with HIV (PLWH) represent an aging demographic with higher-than-average cannabis use rates.

    Purpose of the Study:

    • To examine trends in cannabis use disorder (CUD) diagnoses from 2000 to 2022.
    • To analyze CUD diagnoses by age, race/ethnicity, sex, comorbidity, and HIV status.

    Main Methods:

    • Analysis of electronic health records from 185,372 individuals (PLWH and people without HIV) in the Veterans Aging Cohort Study-HIV (2000-2022).
    • Annual CUD diagnosis rates were calculated and trends were examined using graphical and multivariable logistic models.

    Main Results:

    • Cannabis use disorder (CUD) increased across all subgroups, with consistently higher rates among PLWH (OR=1.14).
    • Individuals aged 65 and older showed the most significant relative increase in CUD diagnoses.
    • Demographics were comparable between PLWH (n=58,959) and people without HIV (n=126,413).

    Conclusions:

    • Cannabis use disorder (CUD) diagnoses have risen dramatically over time, particularly in people living with HIV (PLWH) and older adults.
    • The rise in CUD among older PLWH and those with multiple comorbidities is concerning due to potential drug interactions.
    • There is an urgent need for universal screening, advanced treatment options, and further research on cannabis use patterns and outcomes in PLWH and people without HIV.