Health outcomes and cognitive effects of marijuana use among persons living with HIV/AIDS

摘要 艾滋病毒感染者（PLWH）是COVID-19大流行中特别脆弱的人群，因为他们 免疫系统受损和合并症（例如，物质使用，心理健康问题）。当前没有任何 研究已经研究了COVID-19的广泛影响（例如，长期的社会孤立、焦虑、家庭 损失）正在影响大麻使用，大麻使用障碍（CUD）和PLWH的护理参与。此外，本发明还 研究还没有澄清长期使用大麻是否会与艾滋病毒感染相互作用，以影响发病， COVID-19感染的进展。这一紧急补充将使我们能够抓住这一机会之窗 并及时收集数据以弥补这些差距。我们正在进行的R 01研究的PLWH队列，重点是 大麻的使用提供了许多独特的优势，以支持这种补充。主动R 01的主要目标 该项目旨在研究大麻使用对认知功能和健康结果的长期影响， 在佛罗里达的PLWH队列（目前有300名参与者完成了基线评估）。本补充 在母补助金的范围内，但通过纳入与COVID-19相关的 问题/措施纳入正在进行的数据收集。我们将使用混合方法收集更多数据 方法，包括定量调查问题和深入的定性访谈，对选定的 子样本我们将使用我们收集的血液样本进行COVID-19抗体测试，作为 家长补助程序。我们还将收集的数据与佛罗里达卫生部EHARS联系起来 关于艾滋病毒相关结果的数据（例如，病毒载量），这也是母研究的一部分。具体 本补充文件的目的包括：1）识别COVID-19疫情对 PLWH中的大麻使用和大麻使用障碍（CUD）; 2）确定COVID-19的影响 艾滋病毒护理连续体上的流行病（即，艾滋病毒护理参与）和成果（即，病毒载量）;以及3） 使用抗体估计2020年9月后我们研究样本中COVID-19感染的患病率 检测IgG和IgM如果我们有足够大的样本（即，10%的COVID-19检测呈阳性），我们将 研究大麻使用状况与COVID-19发病率/严重程度之间的关联。本研究将 第一个解决2019冠状病毒病大流行对正在进行的艾滋病毒携带者队列的影响，重点是 大麻使用及其相关的健康结果。通过收集额外的COVID-19相关信息作为 作为父母研究中定期随访的一部分，我们将能够提供有关如何 COVID-19大流行可能会导致PLWH的大麻使用/CUD和艾滋病毒护理/结果发生变化， 能够识别这些变化的潜在机制。抗体测试的结果也可能提供 关于大麻使用是否与艾滋病毒相互作用影响COVID-19发病率和严重程度的信息数据， 这可能会为该人群未来的COVID-19预防和治疗计划提供信息。

Abstract Persons living with HIV (PLWH) are an especially vulnerable population in the COVID-19 pandemic given their compromised immune system and comorbidities (e.g., substance use, mental health issues). Currently, no research has examined how the broad impacts of COVID-19 (e.g., extended social isolation, anxiety, family loss) are affecting marijuana use, cannabis use disorder (CUD), and care engagement in PLWH. Further, research has not clarified whether chronic marijuana use will interact with HIV infection to impact the onset and progression of COVID-19 infection. This urgent supplement will allow us to capture this window of opportunity and collect timely data to address these gaps. Our ongoing R01 study of a PLWH cohort focusing on marijuana use provides many unique strengths to support this supplement. The primary goal of the active R01 project is to examine the long-term impact of marijuana use on cognitive functioning and health outcomes in a cohort of PLWH (currently 300 participants completed baseline assessment) in Florida. This supplement is within the scope of the parent grant but extends the parent study by incorporating COVID-19-related questions/measures into the ongoing data collection. We will collect additional data using a mixed method approach which includes quantitative survey questions and in-depth qualitative interviews on a selected subsample. We will conduct COVID-19 antibody tests using the blood sample we collect as a part of the parent grant procedures. We will also link the collected data with the Florida Department of Health EHARS data on HIV-related outcomes (e.g., viral load) over time, which is also a part of the parent study. The specific aims of this supplement include: 1) To identify the impact of the COVID-19 pandemic on changes in marijuana use and cannabis use disorder (CUD) among PLWH; 2) To determine the impact of the COVID-19 pandemic on the HIV care continuum (i.e., HIV care engagement) and outcomes (i.e., viral load); and 3) To estimate the prevalence of COVID-19 infection in our study sample after September 2020, using antibody testing for IgG and IgM. If we have a large enough sample (i.e., 10% tested positive for COVID-19), we will examine the association between marijuana use status and COVID-19 incidence/severity. This study will be the first to address the impacts of the COVID-19 pandemic among an ongoing cohort of PLWH with a focus on marijuana use and its related health outcomes. By collecting additional COVID-19-related information as a part of the regular follow-ups in the parent study, we will be able to provide valuable evidence on how the COVID-19 pandemic may cause changes in PLWH’s marijuana use/CUD and HIV care/outcomes and will be able to identify the underlying mechanism of these changes. Results from the antibody tests may also provide informative data on whether marijuana use interacts with HIV in affecting COVID-19 incidence and severity, which can potentially inform future prevention and treatment programs for COVID-19 in this population.