Joint effects of human immunodeficiency virus (HIV) and cannabis on neurocognition

Cannabis has become increasingly accessible to populations living with chronic health conditions such as HIV. Many people living with HIV are turning to cannabis for symptom relief despite the unclear risks to neurocognitive health. Our study sought to replicate and extend prior research by examining global and domain-specific neurocognitive performance between four groups stratified by use of cannabis (CB; CB+/CB-) and HIV serostatus (HIV+/HIV-).

Our demographically diverse community sample (N = 269) underwent exclusion and inclusion criteria to isolate the effects of cannabis use (CU) and HIV on neurocognition. We explored between-group comparisons of neurocognitive performance, probability of neurocognitive impairment, and interactive effects of CU/HIV serostatus.

Between-group comparisons revealed nonsignificant differences in global or domain-specific neurocognitive performance. However, the CB+/HIV+ group was three times (99% CI [1.18, 9.57]) more likely to be labeled with a memory impairment compared to the control (CB-/HIV-), and the CB+/HIV- group was twice (99% CI [.14, 7.47]) as likely to be labeled with an executive functioning impairment compared to the control. We also identified an interactive effect between the past 30-day CU and HIV serostatus for global (b = -.026, 99% CI [-.04, -.01]) and motor (b = -.052, 99% CI [-.07, -.03]) neurocognitive performance. Findings support a nuanced relationship between CU and HIV, which may partly explain mixed literature.

Although we conclude that recent and heavy CU poses risk of neurocognitive decline among people living with HIVs, this effect is modest. Physicians and patients must weigh a possible decrease in global and motor neurocognition against the severity of symptoms being treated. (PsycInfo Database Record (c) 2025 APA, all rights reserved).