Only 14% of HIV-positive cannabis users had medical authorization despite legal access | Research

The takeaway

Among 868 HIV-positive cannabis users in Ontario where recreational cannabis is legal, only 14% used medical cannabis, with those choosing the medical stream reporting worse physical health, more HIV symptoms, and more frequent cannabis use.

HIV care providers, medical cannabis clinicians, cannabis policy researchers

Only 14% of HIV-positive cannabis users accessed the medical stream despite legal availability

What the researchers found

Only 14.06% used any medical cannabis; medical users had greater HIV symptom distress, poorer physical health quality of life, more frequent use, and preferred smokeless forms; 85.94% used exclusively non-medical cannabis.

Why it matters

Even where recreational cannabis is legal, a subset of patients with HIV continue to access medical cannabis, and they represent a sicker population using cannabis more therapeutically.

The numbers in context

868 participants; 85.37% male; mean age 51.34; 14.06% any medical cannabis use; medical users had greater symptom distress, poorer physical QoL, more frequent use, and more smokeless methods.

How the study worked

Cross-sectional analysis of 868 HIV-positive cannabis users in the Ontario HIV Treatment Network Cohort Study (2022); logistic regression comparing medical vs exclusively non-medical cannabis users.

What this study cannot tell us

Cross-sectional; Ontario-specific legal context; self-reported cannabis authorization; predominantly male sample; cannot determine if medical cannabis is causally related to better health management.

How to read the evidence

Well-characterized HIV cohort with relevant clinical measures, but cross-sectional and predominantly male sample limit causal and demographic conclusions.

When this study was published

Published 2025, data from 2022

The bigger picture

Dual medical/recreational cannabis frameworks create distinct user populations, with medical users potentially benefiting from clinical guidance that purely recreational channels do not provide.

Questions still open

Why do most HIV-positive cannabis users avoid the medical stream? Would more accessing medical cannabis improve health outcomes? Is smokeless preference driven by health awareness or clinical advice?

Common questions

Do HIV patients use medical or recreational cannabis?

Mostly recreational. Only 14% had medical authorization despite legal access to both streams. Those choosing medical cannabis were sicker and used more frequently.

How did medical cannabis users differ?

They had greater HIV symptom distress, poorer physical health, used cannabis more often, and preferred smokeless forms like oils and edibles over smoking.

Read the original research

Correlates of Using Medically-Authorized Cannabis in a Large Cohort of People Living with HIV Who Use Cannabis.

AIDS and behavior, 29(3), 858-869

View on PubMed ↗Publisher’s paper ↗

Citation

Coelho, Sophie G; Wardell, Jeffrey D; Kroch, Abigail; Rueda, Sergio. (2025). Correlates of Using Medically-Authorized Cannabis in a Large Cohort of People Living with HIV Who Use Cannabis.. AIDS and behavior, 29(3), 858-869. https://doi.org/10.1007/s10461-024-04568-9