Among 1,246 women with HIV, cannabis use was twice the national average, with smoking dominant (96%), half of users changing their frequency over 18 months, and 15% using daily.
HIV care providers, women's health specialists, substance use researchers
What the researchers found
In the Women's Interagency HIV Study (2018-2019), 27% of 1,246 women with HIV used cannabis and 15% used daily. Smoking was the dominant mode (96%), followed by edibles (30%) and vaping (18%). Notably, 50% of users reported varying use frequencies across time points, suggesting unstable use patterns. Cannabis users had significantly higher rates of alcohol (69% vs 37%), cigarette (61% vs 29%), and other drug use (16% vs 4%).
Why it matters
Women with HIV are an aging population where cannabis use is twice the national average. The finding that half of users change their frequency over time challenges assumptions about stable use patterns and has implications for how providers assess and discuss cannabis use.
The numbers in context
1,246 women with HIV; median age 52; 65% Black/African American; 27% any cannabis use; 15% daily use; 96% smoked; 30% edibles; 18% vaped; 50% varied frequency; higher concurrent alcohol (69% vs 37%) and cigarette use (61% vs 29%)
How the study worked
Longitudinal analysis of 1,246 women with HIV in the WIHS over 18 months (2018-2019). Characterized prevalence, frequency, and modes of cannabis use. Compared demographics and health behaviors between users and non-users. Sankey diagrams illustrated transitions between use frequency categories.
What this study cannot tell us
Single cohort of predominantly Black, low-income women with HIV; may not generalize. Self-report measures. 18-month window may not capture longer-term patterns. Cannot assess health outcomes associated with different use patterns.
How to read the evidence
Moderate: established longitudinal cohort with detailed use characterization, but single-study with specific demographics.
When this study was published
2025 publication using 2018-2019 data
The bigger picture
As women with HIV live longer due to effective antiretroviral therapy, understanding their substance use patterns becomes increasingly important for managing aging-related comorbidities and potential drug interactions.
Questions still open
- How does cannabis use interact with antiretroviral medications in this population?
- What drives the unstable use patterns, and do transitions to higher frequency predict health outcomes?
Read the original research
Patterns of Cannabis Use among Women With HIV in the United States.
AIDS and behavior, 29(6), 2022-2032
Citation
Haley, Danielle F; Bullington, Brooke W; Tien, Phyllis; Knittel, Andrea K; Bobitt, Julie; Kempf, Mirjam-Colette; Philbin, Morgan; Hanna, David B; Lindsey, StarrLa'diamond; Kassaye, Seble; DeHovitz, Jack; Cohen, Mardge; Wingood, Gina; Jones, Deborah L; Williams, Michael P; Wang, Richard J; Edmonds, Andrew. (2025). Patterns of Cannabis Use among Women With HIV in the United States.. AIDS and behavior, 29(6), 2022-2032. https://doi.org/10.1007/s10461-025-04669-z
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