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

摘要 艾滋病毒携带者是新冠肺炎大流行中的一个特别脆弱的人群，因为他们 免疫系统受损和合并症(例如，药物使用、精神健康问题)。目前，没有 研究考察了新冠肺炎的广泛影响(例如，延长社交孤立、焦虑、家庭 损失)正在影响大麻使用、大麻使用障碍(CUD)和公共卫生部门的护理参与。此外， 研究还没有明确长期使用大麻是否会与艾滋病毒感染相互作用，从而影响发病和 新冠肺炎感染的进展。这份紧急补充材料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。我们正在进行的关于PLWH队列的R01研究重点是 大麻的使用提供了许多独特的优势来支持这一补充。主动式R01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 佛罗里达州的PLWH队列(目前有300名参与者完成了基线评估)。这份副刊是 在家长资助范围内，但通过纳入与新冠肺炎相关的项目来扩展家长研究 在正在进行的数据收集中提出问题/措施。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对选定的 二次抽样。我们将使用我们收集的血液样本进行新冠肺炎抗体测试 家长补助程序。我们还将把收集的数据与佛罗里达州卫生部EHARS联系起来 关于艾滋病毒相关结果(例如，病毒载量)随时间的变化的数据，这也是父母研究的一部分。具体的 本补编的目的包括：1)确定新冠肺炎大流行对全球变化的影响 公共卫生部门中的大麻使用和大麻使用障碍(CUD)；2)确定新冠肺炎的影响 大流行病对艾滋病毒护理连续体(即艾滋病毒护理参与)和结果(即病毒载量)的影响；以及3) 使用抗体估计2020年9月后我们研究样本中新冠肺炎感染的流行率 检测免疫球蛋白和免疫球蛋白M。如果我们有足够大的样本(即10%的新冠肺炎检测呈阳性)，我们将 研究大麻使用状况与新冠肺炎发病率/严重性之间的关系。这项研究将是 第一个在公共卫生部门的持续队列中应对新冠肺炎大流行的影响，重点是 大麻使用及其相关的健康后果。通过收集其他与新冠肺炎相关的信息作为 作为家长研究的定期随访的一部分，我们将能够提供有价值的证据，说明 新冠肺炎大流行可能会导致菲律宾卫生署大麻使用/CUD和艾滋病毒护理/结果的变化，并将 能够确定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新冠肺炎发病率和严重程度的信息数据， 这可能会为未来在该人群中开展新冠肺炎的预防和治疗计划提供参考。

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.