Early-Onset, Regular Marijuana Use Is Associated with Learning and Memory Impairment in People Living With HIV

Early-onset (<18 years of age) marijuana use may result in deficits in cognitive functioning. Individuals living with HIV experience cognitive impairment and also have disproportionately high rates of marijuana use. This cross sectional study of adults living with HIV examined the associations between regular marijuana use (defined as ≥3 times/week), onset age of regular marijuana use, HIV biomarkers, and neurocognitive test performance.

• 69 participants had been living with HIV for a mean of 11 years; 73% were male, 77% were African American, and 90% had a high school degree or a GED.
• There were no significant differences in measured neurocognitive impairment between people with late onset (at ≥18 years old) regular marijuana use and those who did not use marijuana regularly.
• People with early onset regular marijuana use were more likely to demonstrate impairment in the cognitive domains of learning (odds ratio [OR], 8.46) and memory (OR, 3.95), but less likely to demonstrate impairment in attention/working memory (OR, 0.11) when compared with people who did not use marijuana regularly.
• Cognitive function was not associated with HIV disease markers (viral load, current CD4 count, nadir CD4 count), nor were there interactions between these biomarkers and marijuana use group.

Comments: The potential for early onset, regular marijuana use to exacerbate memory impairment among people with HIV may have clinical implications, including compromised adherence to critical antiretroviral medication regimens. The balance of risks and potential benefits of marijuana use remain unclear.

Jeoffrey Hill, MD† and Marc R. Larochelle, MD, MPH

† Contributing editorial intern and Addiction Medicine Fellow, Boston Medical Center/Boston University School of Medicine

Reference: Skalski LM, Towe SL, Sikkema KJ, Meade CS . Memory impairment in HIV-infected individuals with early and late initiation of regular marijuana use. AIDS Behav. 2018;22(5):1596–1605.