Cannabis and alcohol co-use and HIV biomedical intervention engagement among Black sexual/gender minority (BSGM) people: A day-level analysis.

IF 4.5 2区医学 Q1 MEDICINE, GENERAL & INTERNAL

American Journal of Preventive Medicine Pub Date : 2025-10-07 DOI:10.1016/j.amepre.2025.108144

Yen-Tyng Chen, Justin Knox, Ellen Almirol, Ella Remund Wiger, Jade Pagkas-Bather, Jimi Huh, Tammy Chung, Devin English, Dustin T Duncan, John A Schneider

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引用次数: 0

Abstract

Introduction: Cannabis and alcohol are the most frequently used substances among Black sexual/gender minority (BSGM) people and co-use of these substances is surging. Little work exists on the association of cannabis/alcohol co-use with HIV prevention and care engagement in this population. We examined daily associations of cannabis/alcohol co-use with pre-exposure prophylaxis (PrEP) and antiretroviral (ARV) medications use, in the context of hazardous alcohol and cannabis use, among BSGM.

Methods: Daily use of cannabis, alcohol, and PrEP/ARV were assessed via 14-day ecological momentary assessment (EMA) in the Neighborhoods and Networks Part 2 (N2P2) cohort study of BSGM in Chicago (2022-2024). Generalized estimating equations models were used to examine day-level associations between cannabis/alcohol co-use and following day PrEP/ARV use.

Results: Across 5,729 days for 521 participants with ≥1 EMA responses, cannabis/alcohol co-use, cannabis-only use, alcohol-only use, and no substance use occurred on 19.8%, 36.5%, 6.3%, and 34.9% days, respectively. Among participants who reported hazardous alcohol use (AUDIT≥8), on cannabis-only days, participants were more likely to report following day PrEP/ARV use (aRR=1.54; 95% CI=1.00, 2.38). Among participants with no hazardous alcohol use, alcohol-only use day was associated with greater following day PrEP/ARV use (aRR=1.34; 95% CI=1.02, 1.76). Cannabis/alcohol co-use was not associated with PrEP/ARV use, regardless of hazardous alcohol or cannabis use status.

Conclusions: Heterogeneity exists regarding associations between cannabis/alcohol co-use and PrEP/ARV use among BSGM, depending on individuals' hazardous alcohol use status. Future research should collect fine-grained contextual data on cannabis/alcohol co-use to examine mechanisms by which co-use influences HIV care engagement.

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黑人性/性别少数群体（BSGM）大麻和酒精的共同使用和参与艾滋病毒生物医学干预：日水平分析。

简介：大麻和酒精是黑人性/性别少数群体（BSGM）中最常用的物质，并且这些物质的共同使用正在激增。在这一人群中，关于大麻/酒精混合使用与艾滋病毒预防和护理参与之间关系的工作很少。在BSGM中，在危险酒精和大麻使用的背景下，我们研究了大麻/酒精共同使用与暴露前预防（PrEP）和抗逆转录病毒（ARV）药物使用的日常关联。方法：通过芝加哥BSGM社区和网络第2部分（N2P2）队列研究（2022-2024）的14天生态瞬时评估（EMA）评估大麻、酒精和PrEP/ARV的日常使用情况。使用广义估计方程模型来检查大麻/酒精共同使用与第二天PrEP/ARV使用之间的日水平关联。结果：在521名EMA反应≥1的参与者的5729天中，大麻/酒精共使用、仅使用大麻、仅使用酒精和无物质使用分别发生在19.8%、36.5%、6.3%和34.9%的天。在报告危险饮酒的参与者中（AUDIT≥8），在仅使用大麻的日子里，参与者更有可能报告第二天使用PrEP/ARV （aRR=1.54; 95% CI=1.00, 2.38）。在没有危险酒精使用的参与者中，只使用酒精的一天与第二天更多的PrEP/ARV使用相关（aRR=1.34; 95% CI=1.02, 1.76）。大麻/酒精的共同使用与PrEP/ARV的使用无关，无论酒精或大麻的使用状况如何。结论：在BSGM中，大麻/酒精共同使用与PrEP/ARV使用之间的关联存在异质性，这取决于个人的危险酒精使用状况。未来的研究应收集大麻/酒精共同使用的细粒度背景数据，以检查共同使用影响艾滋病毒护理参与的机制。

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来源期刊

American Journal of Preventive Medicine 医学-公共卫生、环境卫生与职业卫生

CiteScore

8.60

自引率

1.80%

发文量

395

审稿时长

32 days

期刊介绍： The American Journal of Preventive Medicine is the official journal of the American College of Preventive Medicine and the Association for Prevention Teaching and Research. It publishes articles in the areas of prevention research, teaching, practice and policy. Original research is published on interventions aimed at the prevention of chronic and acute disease and the promotion of individual and community health. Of particular emphasis are papers that address the primary and secondary prevention of important clinical, behavioral and public health issues such as injury and violence, infectious disease, women''s health, smoking, sedentary behaviors and physical activity, nutrition, diabetes, obesity, and substance use disorders. Papers also address educational initiatives aimed at improving the ability of health professionals to provide effective clinical prevention and public health services. Papers on health services research pertinent to prevention and public health are also published. The journal also publishes official policy statements from the two co-sponsoring organizations, review articles, media reviews, and editorials. Finally, the journal periodically publishes supplements and special theme issues devoted to areas of current interest to the prevention community.