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

描述（由申请人提供）：大麻在艾滋病毒/艾滋病患者中很常见。大麻在艾滋病毒症状管理方面的医疗用途继续得到认可，最近对州法律的修改使艾滋病毒血清阳性（艾滋病毒阳性）个人越来越容易获得大麻。虽然大麻具有治疗潜力，但它的使用也会导致神经认知缺陷。这是艾滋病毒感染者特别关注的问题，他们已经很容易受到这种损害。事实上，大量的研究表明，滥用各种物质往往会加重艾滋病毒相关的神经认知缺陷。然而，尽管大麻被广泛使用，但它对这一人群的影响却相对未被探索。关于大麻使用可能给HIV+个体带来的神经认知障碍的类型和程度，它们对重要功能行为（例如，药物管理）的影响，或潜在机制，我们知之甚少。拟议的项目将通过首先严格描述大麻使用和艾滋病毒与400名社区居住成年人的神经心理功能之间的关系来解决这些问题，按艾滋病毒血清状态和大麻使用分层。第二个目的是研究大麻使用如何对艾滋病毒阳性个体的重要功能性“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，该模型包括大麻使用可能直接和间接影响艾滋病毒+个体神经认知功能的几种机制。该模型是基于强有力的临床前证据，表明大麻素具有免疫抑制和抗炎作用。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减轻艾滋病毒感染者的神经认知缺陷。这一建议的结果将产生更全面的了解大麻使用如何影响艾滋病毒+个体的神经认知。我们的发现有可能改善艾滋病毒阳性个体的健康和生活质量，进一步研究神经艾滋病，并为艾滋病毒/艾滋病患者使用大麻的医疗保健决策和政策提供信息。

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. PUBLIC HEALTH RELEVANCE: This study will help us understand if cannabis use affects the neurocognitive functioning of HIV+ individuals and whether it impairs their ability to conduct important daily activities (e.g., managing medications and finances). It will also reveal if the effects of cannabis use on immune functioning and inflammatory processes are possible underlying mechanisms for its neurocognitive effects. The new information provided by our study has the potential to improve the health of individuals living with HIV/AIDS and may help policy makers and healthcare providers in deciding the role of cannabis in HIV/AIDS patient care.