CROI 2024 Abstract eBook

Abstract eBook

Poster Abstracts

1004 Pre-Pandemic Patterns of Cannabis Use Among Women With HIV in the United States Richard J. Wang 1 , Brooke Bullington 2 , Phyllis Tien 1 , Bhatt Surya 3 , M. Bradley Drummond 2 , Gypsyamber D'Souza 4 , Robert Foronjy 5 , Antonina Foster 6 , Deepa Lazarous 7 , Anjali Sharma 8 , Kathleen Weber 9 , Deborah Jones Weiss 10 , Danielle F. Haley 11 , Andrew Edmonds 2 1 University of California San Francisco, San Francisco, CA, USA, 2 University of North Carolina at Chapel Hill, Chapel Hill, NC, USA, 3 University of Alabama at Birmingham, Birmingham, AL, USA, 4 The Johns Hopkins University, Baltimore, MD, USA, 5 State University of New York Downstate Medical Center Downstate Medical Center, Brooklyn, NY, USA, 6 Emory University, Atlanta, GA, USA, 7 Georgetown University, Washington, DC, USA, 8 Albert Einstein College of Medicine, Bronx, NY, USA, 9 Cook County Health & Hospitals System, Chicago, IL, USA, 10 University of Miami, Miami, FL, USA, 11 Boston University, Boston, MA, USA Background: The regulatory environment for marijuana and other cannabis products is changing quickly across the United States, and use has increased over the past decade. The contemporary prevalence of use, frequency of use, and uptake of newer cannabis products, such as vape products, is unknown for women with HIV. Because cannabis products can pose health risks and have immunomodulatory effects mediated by cannabinoid receptors, it is important to understand patterns of cannabis use among women with HIV. Methods: This analysis includes 1,246 women with HIV enrolled in the Women's Interagency HIV Study (WIHS) who attended three semi-annual study visits between April 2018 and September 2019. Data on cannabis use were collected at each visit. A Sankey diagram illustrates the flow of participants between different categories of use frequency over the follow-up period. Results: The period prevalence of cannabis use was 27%. 26% reported smoking marijuana, 8% reported enteric consumption of cannabis products, and 5% reported vaping cannabis products. The prevalence of daily cannabis use was 15%. There was no significant difference in the prevalence of use between sites in states with laws permitting adult or medical use and in states without. Cannabis users were younger, less likely to be employed, and more likely to have used tobacco, alcohol, and other substances. The proportion of users who reported vaping cannabis products increased from 10% in 2018 to 14% in 2019. Compared to cannabis users who did not vape, cannabis users who vaped were more likely to be employed and have a college degree. They were less likely to have smoked cigarettes and more likely to have used e-cigarettes. They were more likely to attend a study site in a permissive jurisdiction. While half of all users reported the same frequency of cannabis use at all three visits, the remaining half of users reported different frequencies of use on at least two visits (Figure 1). Conclusion: In a cohort of women who are representative of women with HIV in the United States, we found a high prevalence of cannabis use in the period immediately preceding the COVID pandemic. Our prevalence estimate is higher than in the general US population and higher than for women with HIV in the WIHS a decade prior, which was 14%. From 2018 to 2019, there was a small increase in the proportion of users who vaped cannabis products. It was not uncommon to report different frequencies of cannabis use at different study visits across 18 months of follow-up.

consumption and HIV viral non-suppression among men compared to the association in women, but no other interaction. Conclusion: These findings suggest that alcohol use measured by a composite of biomarker/self-report is associated with HIV viral non-suppression, particularly among men with HIV on ART. Associations using both PEth/ self-report and PEth alone were stronger than when using self-report alone. Objective measurement of alcohol use may lead to more accurate findings regarding the relationship between alcohol use and HIV outcomes.

1003 Associations of Alcohol Consumption With Long-Term Mortality of ART-Naive Persons Seeking HIV Care Daniel Fuster 1 , Paola Zuluaga 1 , Enric Abelli-Deulofeu 1 , Laura Bermejo 2 , Santiago Moreno 3 , Lucio J. García-Fraile 4 , Jose Antonio Iribarren 5 , Cristina Moreno 6 , Ines Suarez-Garcia 7 , David Vinuesa 8 , Vicente Estrada 9 , Julian Olalla Sierra 10 , Juan Macias 11 , Inma Jarrin 6 , Robert Muga 1 1 Hospital Germans Trias i Pujol, Barcelona, Spain, 2 Hospital Universitario 12 de Octubre, Madrid, Spain, 3 Hospital Ramón y Cajal, Madrid, Spain, 4 Hospital Universitario de La Princesa, Madrid, Spain, 5 Hospital Donostia, San Sebastián, Spain, 6 Institute of Health Carlos III, Madrid, Spain, 7 Hospital Universitario Reina Sofia, Cordoba, Spain, 8 Hospital Universitario San Cecilio, Granada, Spain, 9 Hospital Universitario Clí¬nico San Carlos, Madrid, Spain, 10 Hospital Costa del Sol, Marbella, Spain, 11 Hospital Universitario de Valme, Seville, Spain Background: HIV infection is associated with several chronic diseases. However, the impact of unhealthy alcohol use on clinical outcomes and survival is a matter of debate. We aimed to examine the role of excessive alcohol consumption on all-cause mortality among ART-naïve individuals admitted to HIV care. Methods: Longitudinal study in the Spanish network on HIV/AIDS (CoRIS) among individuals enrolled between 2004 and 2021 in 47 HIV/AIDS units. We analyzed crude and adjusted mortality rates by alcohol consumption at first visit. Cox proportional hazard models were used to assess the association between excessive alcohol consumption (>40 gr/day) and mortality after controlling for confounders [i.e., age at first visit, sex, HCV infection (EIA+), CD4 cell count and HIV-RNA viral load and persons who inject drugs as mode of HIV acquisition (PWID)]. Results: 8,378 participants (15% women) were included; median age at first visit was 37 years (IQR: 29-44 years). Men who had sex with men (MSM) accounted for 61% of the participants, 28% were heterosexuals and 6.3% were PWID. Among drinkers (38% of the study population), mean alcohol consumption was 70 grams per week (± 23.6 gr). In addition, 4.3% of participants reported alcohol consumption >40 grams/day. The prevalence of alcohol consumption >40 grams/day was higher among PWID (26%) than among MSM (2.4%) or heterosexuals (5.3%) Prevalence of HCV infection was 8.8%, median log RNA-HIV load was 4.54 (IQR: 3.67-5.13) and median CD4 count was 398 cells/ mm 3 (IQR: 219-596). After a median follow up of 5.6 years (IQR: 2.5-9.8 years) and a total follow-up of 52,799 person-years (p-y), 267 participants (3.1%) had died. Crude mortality rate of those who drank >40 grams/day was 2.09 x 100 p-y vs. 0.43 x 100 p-y among those who drank <40 grams/day [RR 4.85 (95% CI: 3.56-6.62), p <0.01]. In the unadjusted analysis, alcohol consumption >40 grams/day (HR 4.28; 95% CI: 3.13-5.83), age greater than the median (HR: 2.16; 95% CI: 1.62-2.89), HCV infection (HR: 5.05; 95% CI: 3.94-6.48), CD4 cell count below the median (HR: 2.58; 95% CI: 1.96-3.40) and PWID (HR: 4.72; 95% CI: 3.64-6.17) were associated with mortality. In the adjusted model, alcohol consumption >40 grams/day was associated with a higher risk of mortality [HR 2.39 (95% CI: 1.68-3.42), p <0.01)]. Conclusion: In this cohort of ART-naïve individuals entering HIV care, unhealthy alcohol use was associated with reduced survival.

Poster Abstracts

CROI 2024 321