Cannabis use disorder diagnoses more than quadrupled among veterans aged 65+ with HIV from 2000 to 2022, with one in five people living with HIV receiving a CUD diagnosis during the study period.
HIV clinicians, geriatricians, addiction medicine specialists, VA healthcare providers, and public health researchers.
What the researchers found
20% of people living with HIV (PLWH) had a cannabis use disorder diagnosis between 2000 and 2022, with CUD consistently higher among PLWH vs. those without HIV (OR=1.14, 95% CI=1.11-1.18), and the greatest relative increase occurring among those aged 65+ (PLWH: 0.9% to 4.0%; PLWoH: 0.03% to 3.15%).
Why it matters
As people with HIV live longer on antiretroviral therapy, rising cannabis use disorder in this aging population is concerning because cannabis can interact with many prescription medications these patients take.
The numbers in context
N=185,372 (58,959 PLWH, 126,413 PLWoH); 45% Black NH, 35% White NH; mean age 48; 20% of PLWH had CUD; OR=1.14 for PLWH vs PLWoH; 65+ age group: 0.9%→4.0% (PLWH), 0.03%→3.15% (PLWoH)
How the study worked
Retrospective analysis of electronic health records from 185,372 individuals in the Veterans Aging Cohort Study-HIV (2000-2022), including 58,959 PLWH matched 1:2 to 126,413 people without HIV, examining CUD trends by age, race/ethnicity, sex, comorbidity, and HIV status.
What this study cannot tell us
VA population (mostly male) limits generalizability; ICD-based diagnosis may undercount CUD; cannot distinguish therapeutic from recreational use; increasing diagnostic coding awareness may inflate trends; observational design.
How to read the evidence
Large matched cohort with 22 years of longitudinal data from a national VA database, providing robust trend evidence despite limitations of diagnostic coding.
When this study was published
Published 2026; covers 2000-2022.
The bigger picture
The intersection of aging, HIV, and increasing cannabis use disorder represents a growing clinical challenge as providers must balance patients' cannabis use with complex medication regimens.
Questions still open
- Is rising CUD among older PLWH driven by self-medication or changing cannabis availability? How does CUD affect antiretroviral therapy adherence and outcomes? Should HIV care include routine CUD screening?
Common questions
Is cannabis use disorder increasing among older adults?
Are people with HIV more likely to develop cannabis use disorder?
Read the original research
Cannabis Use Disorder Among People With and Without HIV.
Journal of addiction medicine, 20(1), 38-43
Citation
Haley, Danielle F; So-Armah, Kaku; Justice, Amy C; Kidwai-Khan, Farah; Xuan, Ziming; Sayko Adams, Rachel; Fox, Matthew P; Edelman, E Jennifer; Wrona, Aleksandra; Silverberg, Michael J; Satre, Derek D; Trickey, Adam; Ingle, Suzanne M; McGinnis, Kathleen A. (2026). Cannabis Use Disorder Among People With and Without HIV.. Journal of addiction medicine, 20(1), 38-43. https://doi.org/10.1097/ADM.0000000000001505
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