Nearly Half of HIV-Positive Adults Over 50 Used Illicit Drugs in the Past Year | Research

The takeaway

Among HIV-positive adults aged 50 and older engaged in care, marijuana was the most commonly used illicit drug at 32.6%, and nearly a quarter met criteria for drug dependence.

Read this if you work in HIV care or want to understand substance use patterns among older adults living with HIV.

32.6% of HIV-positive adults over 50 used marijuana in the past year.

What the researchers found

In a sample of 95 HIV-positive patients aged 50 and older who were actively engaged in medical care, substance use was highly prevalent. Nearly half (48.4%) had used an illicit drug in the past 12 months, and 23.2% met criteria for drug dependence.

Marijuana was the most commonly reported illicit drug at 32.6%, followed by cocaine and crack at 10.5% each. Most participants (81.1%) were at medium risk for an alcohol use disorder.

Among those who had used drugs in the past year, 37% had never been in any substance use treatment. Among those meeting dependence criteria, 27.3% had never participated in a 12-step program.

Why it matters

The population of people living with HIV aged 50 and older is growing due to effective antiretroviral therapy. High rates of substance use in this population intersect with complex medication regimens, age-related health conditions, and potential drug interactions. The finding that over a third of active drug users had never received treatment suggests a significant gap in integrated care.

The numbers in context

95 participants. 48.4% used illicit drugs in the past year. 32.6% used marijuana. 23.2% met drug dependence criteria. 46.3% were current cigarette smokers. 37% of past-year drug users had never been in treatment.

How the study worked

This was a cross-sectional study of 95 HIV-positive patients aged 50 and older recruited from two community health settings in New York City. Participants completed assessments of alcohol, tobacco, and illicit drug use, treatment history, and 12-step program participation.

What this study cannot tell us

Small sample size (95 participants) from New York City limits generalizability. The study was cross-sectional and relied on self-reported drug use. Participants were all engaged in care, so those not in treatment may have different patterns. The study did not distinguish between medical and recreational cannabis use.

How to read the evidence

Preliminary evidence from a small cross-sectional study at two sites in one city. Useful for identifying patterns but not generalizable.

When this study was published

Published in 2016. The aging HIV population and attitudes toward cannabis have both evolved since this study.

The bigger picture

As people with HIV live longer, the intersection of aging, chronic disease management, and substance use becomes increasingly important. Cannabis was the most commonly used substance in this population, which raises questions about whether some use may be therapeutic (for appetite, pain, or nausea) versus recreational, and how clinicians should approach it.

Questions still open

Are some older HIV-positive adults using cannabis to manage symptoms like nausea, pain, or appetite loss? How does cannabis use interact with antiretroviral medications in older adults? Would integrated substance use screening and treatment in HIV clinics improve outcomes?

Common questions

Is marijuana use common among older adults with HIV?

In this study of 95 HIV-positive adults over 50, nearly a third reported marijuana use in the past year, making it the most commonly used illicit drug in this population.

Were these people using marijuana medically?

The study did not distinguish between medical and recreational use. Given that many people with HIV experience symptoms that cannabis may address (nausea, appetite loss, pain), some use may have been symptom management.

Read the original research

Drug use among HIV+ adults aged 50 and older: findings from the GOLD II study.

AIDS care, 28(11), 1373-7

View on PubMed ↗Publisher’s paper ↗

Citation

Ompad, Danielle C; Giobazolia, Tatiana T; Barton, Staci C; Halkitis, Sophia N; Boone, Cheriko A; Halkitis, Perry N; Kapadia, Farzana; Urbina, Antonio. (2016). Drug use among HIV+ adults aged 50 and older: findings from the GOLD II study.. AIDS care, 28(11), 1373-7. https://doi.org/10.1080/09540121.2016.1178704