ArticleAmerican journal of preventive medicine2026
Cannabis and Alcohol Co-Use And HIV Biomedical Intervention Engagement Among Black Sexual/Gender Minority People: A Day-Level Analysis.
Article in American journal of preventive medicine, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
introductionCannabis and alcohol are the most frequently used substances among Black sexual/gender minority people, and co-use of these substances is surging. Little work exists on the association of cannabis/alcohol co-use with HIV prevention and care engagement in this population. The authors examined daily associations of cannabis/alcohol co-use with pre-exposure prophylaxis and antiretroviral medications use, in the context of hazardous alcohol and cannabis use, among Black sexual/gender minority.
methodsDaily use of cannabis, alcohol, and pre-exposure prophylaxis/antiretroviral medication was assessed through 14-day ecologic momentary assessment in the Neighborhoods and Networks Part 2 cohort study of Black sexual/gender minority in Chicago (2022-2024). Generalized estimating equations models were used to examine day-level associations between cannabis/alcohol co-use and following-day pre-exposure prophylaxis/antiretroviral medication use.
resultsAcross 5,729 days for 521 participants with ≥1 ecologic momentary assessment responses, cannabis/alcohol co-use, cannabis-only use, alcohol-only use, and no substance use occurred on 19.8%, 36.5%, 6.3%, and 34.9% days, respectively. Among participants who reported hazardous alcohol use (Alcohol Use Disorders Identification test≥8), on cannabis-only days, participants were more likely to report following-day pre-exposure prophylaxis/antiretroviral medication use (adjusted RR=1.54; 95% CI=1.00, 2.38). Among participants with no hazardous alcohol use, alcohol-only use day was associated with greater following-day pre-exposure prophylaxis/antiretroviral medication use (adjusted RR=1.34; 95% CI=1.02, 1.76). Cannabis/alcohol co-use was not associated with pre-exposure prophylaxis/antiretroviral medication use, regardless of hazardous alcohol or cannabis use status.
conclusionsHeterogeneity exists regarding the associations between cannabis/alcohol co-use and pre-exposure prophylaxis/antiretroviral medication use among Black sexual/gender minority, depending on individuals' hazardous alcohol use status. Future research should collect fine-grained contextual data on cannabis/alcohol co-use to examine the mechanisms through which co-use influences HIV care engagement.
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