The Impact of Cannabis Use on the Neurocognitive Functioning of Individuals with

说明(申请人提供)：吸食大麻在感染艾滋病毒/艾滋病的个人中很常见。它用于艾滋病毒症状管理的医疗用途继续得到接受，最近对州法律的修改使艾滋病毒血清阳性(HIV+)个人获得大麻变得越来越容易。虽然大麻具有治疗潜力，但众所周知，它的使用也会导致神经认知障碍。这对艾滋病毒携带者特别令人担忧，他们已经容易受到这种损害的影响。事实上，大量研究表明，各种滥用物质往往会加剧艾滋病毒相关的神经认知缺陷。然而，尽管大麻被广泛使用，但大麻对这一人群的影响相对来说还没有被研究过。关于使用大麻可能对艾滋病毒感染者造成的神经认知损害的类型和程度、其对重要功能行为(例如，用药管理)的影响或潜在机制，人们知之甚少。拟议的项目将首先在400名社区成年人中严格描述大麻使用和艾滋病毒与神经心理功能的关系，并按艾滋病毒血清学和大麻使用情况进行分层，从而解决这些问题。第二个目标是研究大麻的使用如何对艾滋病毒携带者的重要功能性“现实世界”行为产生不利影响。最终目的是测试一个理论驱动的模型，该模型包括几种机制，通过这些机制，大麻的使用可能直接和间接影响艾滋病毒携带者的神经认知功能。这一模型是基于强有力的临床前证据，表明大麻类化合物既有免疫抑制作用，又有抗炎作用。结构方程模型将用于测试大麻对神经认知的任何直接影响，以及可能由其免疫抑制特性驱动的任何间接影响。该模型将同时检查大麻的抗炎作用是否有助于缓解艾滋病毒携带者的神经认知缺陷。这项提议的结果将使人们更全面地了解大麻的使用如何影响艾滋病毒感染者的神经认知。我们的发现有可能改善艾滋病毒+患者的健康和生活质量，进一步开展神经艾滋病研究，并为有关艾滋病毒/艾滋病患者使用大麻的医疗决策和政策提供参考。

DESCRIPTION (provided by applicant): Cannabis use is common among individuals with HIV/AIDS. Its medical use for HIV symptom management continues to gain acceptance and recent changes to state laws have made it increasingly easier for HIV-seropositive (HIV+) individuals to obtain cannabis. Although cannabis has therapeutic potential, its use is also known to cause neurocognitive deficits. This is of particular concern to individuals with HIV, who are already vulnerable to such impairments. Indeed, a substantial amount of research shows that various substances of abuse often compound HIV-associated neurocognitive deficits. Yet, despite its widespread use, the effects of cannabis in this population have been relatively unexplored. Little is known regarding the type and extent of neurocognitive impairments that cannabis use may confer to HIV+ individuals, their impact on important functional behaviors (e.g., medication management), or the underlying mechanisms. The proposed project will address these issues by first characterizing rigorously how cannabis use and HIV relate to neuropsychological functioning in a large cohort of 400 community-dwelling adults, stratified by HIV-serostatus and cannabis use. The second aim examines how cannabis use may adversely affect important functional "real-world" behaviors of HIV+ individuals. The final aim tests a theory-driven model that includes several mechanisms through which cannabis use may directly and indirectly influence neurocognitive functioning among HIV+ individuals. This model is based on strong preclinical evidence showing both immunosuppressive and anti-inflammatory effects of cannabinoids. Structural equation modeling will be used to test any direct effects that cannabis has on neurocognition, as well as any indirect effects that may be driven by its immunosupressive properties. The model will simultaneously examine if anti-inflammatory effects from cannabis are serving to mitigate neurocognitive deficits among those with HIV. The results of this proposal will yield a more complete understanding of how cannabis use influences neurocognition among HIV+ individuals. Our findings have the potential to improve the health and quality of life of HIV+ individuals, further neuroAIDS research, and inform healthcare decisions and policies regarding use of cannabis among individuals with HIV/AIDS.