Anxiety and Tobacco Use Predict Cannabis Problems in People With HIV
Among nearly 1,000 people with HIV who use cannabis, anxiety and concurrent tobacco use were the strongest predictors of higher-risk cannabis use.
Quick Facts
What This Study Found
Of 973 people with HIV, 35.9% screened positive for higher risk of cannabis use disorder. In multivariable analysis, Black race (OR=1.90), anxiety (OR=1.91), and higher-risk tobacco use (OR=2.25) were independently associated with higher CUD risk.
Key Numbers
N=973, 94.1% male, 58.5% White, median age 54.5. 35.9% at higher CUD risk. Black race OR=1.90, anxiety OR=1.91, higher-risk tobacco use OR=2.25.
How They Did This
Cross-sectional analysis of TAPS screening data from 973 people with HIV across 3 primary care clinics in Kaiser Permanente Northern California.
Why This Research Matters
Cannabis use is common among people with HIV, and identifying who is at highest risk for problematic use helps target screening and intervention efforts in a population already managing complex health needs.
The Bigger Picture
Substance use, mental health, and HIV management are deeply interconnected. This study suggests that addressing anxiety and tobacco use could be entry points for preventing cannabis-related problems in this population.
What This Study Doesn't Tell Us
Cross-sectional design cannot establish causation. Predominantly male sample from one healthcare system. TAPS screening is a brief tool that may not capture the full complexity of cannabis use patterns.
Questions This Raises
- ?Would treating anxiety reduce cannabis-related problems in people with HIV?
- ?Could integrated substance use interventions address tobacco and cannabis simultaneously?
Trust & Context
- Key Stat:
- 35.9% of HIV patients who use cannabis screened positive for higher CUD risk
- Evidence Grade:
- Moderate-sized clinical sample with multivariable analysis, but cross-sectional design and single healthcare system limit generalizability.
- Study Age:
- 2025 study from Kaiser Permanente Northern California HIV clinics.
- Original Title:
- Substance use and mental health factors associated with self-reported higher risk cannabis use among people with HIV screened in primary care.
- Published In:
- BMC public health, 25(1), 2580 (2025)
- Authors:
- Mian, Maha N(8), Sarovar, V, Levine, T, Lea, A, Leibowitz, A, Luu, M, Flamm, J, Hare, C B, Horberg, M, Young-Wolff, K C, Phillips, K T, Silverberg, M J, Satre, D D
- Database ID:
- RTHC-07130
Evidence Hierarchy
A snapshot of a population at one point in time.
What do these levels mean? →Frequently Asked Questions
Is cannabis use common among people with HIV?
Yes. In this study of nearly 1,000 people with HIV who were screened for substance use, cannabis use was prevalent, and over a third showed signs of higher-risk use or cannabis use disorder.
What increases the risk of cannabis problems in people with HIV?
Anxiety and concurrent tobacco use were the strongest independent predictors of higher-risk cannabis use in this study, suggesting these could be targets for integrated prevention efforts.
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Cite This Study
https://rethinkthc.com/research/RTHC-07130APA
Mian, Maha N; Sarovar, V; Levine, T; Lea, A; Leibowitz, A; Luu, M; Flamm, J; Hare, C B; Horberg, M; Young-Wolff, K C; Phillips, K T; Silverberg, M J; Satre, D D. (2025). Substance use and mental health factors associated with self-reported higher risk cannabis use among people with HIV screened in primary care.. BMC public health, 25(1), 2580. https://doi.org/10.1186/s12889-025-23735-8
MLA
Mian, Maha N, et al. "Substance use and mental health factors associated with self-reported higher risk cannabis use among people with HIV screened in primary care.." BMC public health, 2025. https://doi.org/10.1186/s12889-025-23735-8
RethinkTHC
RethinkTHC Research Database. "Substance use and mental health factors associated with self..." RTHC-07130. Retrieved from https://rethinkthc.com/research/mian-2025-substance-use-and-mental
Access the Original Study
Study data sourced from PubMed, a service of the U.S. National Library of Medicine, National Institutes of Health.
This study breakdown was produced by the RethinkTHC research team. We analyze and report published research findings without making health recommendations. All interpretations are based solely on the published abstract and study data.