Evidence map›Paper›PMID 42067947›Full record

ArticleJournal of cannabis research2026

Longitudinal analysis of symptoms and healthcare utilization among daily cannabis-using persons living with HIV: impact of co-occurring cocaine use.

Valden A Denha, Leslie H Lundahl, Jonathan A Cohn, Mark K Greenwald, Eric A Woodcock

Registry-linked trialAbstract read
In one paragraph

Article in Journal of cannabis research, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT01536899 (Behavioral Economic Analysis of Medical Marijuana Use in HIV+ Patients Prospective Cohort Study), which is not on this map. Not yet cited in PubMed.

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1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT01536899 completednot on this map

Behavioral Economic Analysis of Medical Marijuana Use in HIV+ Patients Prospective Cohort Study

TypeobservationalSponsorWayne State UniversityRan2012 to 2017Enrolled119ConditionsHIV Positive, Marijuana Smoking
3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

5 authors.

Valden A DenhaDepartment of Population and Health Sciences, School of Public Health, University of Michigan, Ann Arbor, MI, USA.
Leslie H LundahlDepartment of Psychiatry and Behavioral Neurosciences, Wayne State University School of Medicine, Detroit, MI, 48201, USA.
Jonathan A CohnDepartment of Internal Medicine, Wayne State University School of Medicine, Detroit, MI, USA.
Mark K Greenwald *Department of Psychiatry and Behavioral Neurosciences, Wayne State University School of Medicine, Detroit, MI, 48201, USA.
Eric A Woodcock *Department of Psychiatry and Behavioral Neurosciences, Wayne State University School of Medicine, Detroit, MI, 48201, USA. eric.woodcock@wayne.edu.

Funding

Behavioral Economic Analysis of Medical Marijuana Use in HIV+ PatientsR01DA032678 · NIDA · WAYNE STATE UNIVERSITY · PI GREENWALD, MARK K · 2011 to 2013
$1.5M
Multimodal Investigation of the Neuroimmune System in Opioid Use DisorderR00DA048125 · NIDA · WAYNE STATE UNIVERSITY · PI WOODCOCK, ERIC ANDREW · 2021 to 2023
$823k
Michigan Department of Health and Human Services Helene Lycaki and Joe Young Sr. FundsNIDA NIH HHS R00 DA048125NIDA NIH HHS R01 DA032678School of Medicine, Wayne State University Gertrude Levin Endowed Chair in Addiction and Pain Biology
6 · The paper itself

Abstract

backgroundCannabis use is common among persons living with human immunodeficiency virus (HIV, PLWH) and has been associated with disrupted sleep, psychiatric symptoms, and increased healthcare utilization. However, the influence of concurrent cocaine and cannabis use on symptom trajectories and healthcare engagement remains unclear.

methodsOne hundred nineteen PLWH who reported daily cannabis use were assessed longitudinally: baseline, 3-month, and 6-month follow-up. Participants were stratified into concurrent cocaine users vs. non-users based on urine drug screen results (Coc + n = 34 vs. Coc- n = 85). Assessments included substance-use characteristics, viral load, healthcare utilization (HIV-specific vs. non-specific medical visits), HIV-related symptoms (poor sleep, fatigue, pain, poor appetite), and psychiatric symptoms (depression, anxiety).

resultsFrom baseline to 6-month follow-up, HIV clinic visit frequency declined 46.7% (p = 0.002), which was predicted by less-frequent baseline cannabis use (p = 0.03). Poor sleep, fatigue, and poor appetite reliably correlated with psychiatric symptom severity (rs = 0.23-0.57), whereas pain severity was most closely linked to non-HIV-specific healthcare utilization (rs = 0.23-0.36). Cocaine co-use was associated with greater non-HIV-specific healthcare utilization, worse sleep, and less-frequent cannabis use (ps < 0.05).

conclusionsAmong daily cannabis-using PLWH, less-frequent cannabis use at study baseline predicted a 47% decline in HIV clinic visits suggesting that frequent cannabis use (or associated factors) may perpetuate continued HIV healthcare utilization. Cocaine co-use was associated with greater healthcare utilization, worse sleep quality, and less-frequent cannabis use, but did modulate self-reported depression or anxiety symptoms. In sum, our findings show a complex interplay between longitudinal patterns of cannabis use, somatic and psychiatric symptom severity, and healthcare utilization among PLWH.

trial registrationThis study was registered at ClinicalTrials.gov (NCT01536899).

Indexed as

CannabisCocaineHealthcare UtilizationHIVPolysubstance Use

Identifiers

PMID42067947
PMCPMC13288851

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.