The Relationship between Cannabis Use, Neurocognition, and Medication Adherence in a Sample of Latinx and Non-Latinx White People Living with HIV
The current study was the first to examine the relationships between current cannabis use, neurocognition, sociocultural factors, and electronically monitored medication adherence in a diverse sample of primarily Latinx PLWH. Specifically, the current study investigated: (1) the relationships between current, non-syndromic cannabis use, ethnoracial status, and U.S. acculturation; (2) the relationships between current, non-syndromic cannabis use and neurocognition, and current, non-syndromic cannabis use, U.S. acculturation, and neurocognition; (3) the relationship between current, non-syndromic cannabis use and ART adherence; and (4) the independent and interactive effects of current, non-syndromic cannabis use, neurocognition, and U.S. acculturation on ART adherence in a well-characterized, primarily Latinx sample of PLWH. Results of the current study revealed several important findings. First, in the overall sample of PLWH, current non-syndromic cannabis users demonstrated similar performance across all neurocognitive outcomes (i.e., global neurocognition, attention/working memory, executive function, processing speed, learning, memory, verbal fluency, and motor ability) compared to non-users. Second, among Latinx PLWH, U.S. acculturation was significantly related to global neurocognition, verbal fluency, and processing speed. Third, current cannabis users had similar ART adherence compared to non-users. Fourth, there were significant and trend-level interactive effects of cannabis use and executive function and cannabis use and attention/working memory on ART adherence. Specifically, cannabis use status changed the direction of the relationships between executive function and ART adherence and attention/working memory and ART adherence from positive in the presence of no use to negative in the presence of current cannabis use. However, cannabis use and neurocognition did not independently impact ART adherence, and groups were similar on neurocognitive and adherence outcomes. Thus, the interactive effects reflect the change in the direction of the relationships between aspects of neurocognition and ART adherence depending on cannabis use status, but do not indicate that current users have poorer adherence. Last, among Latinx PLWH, U.S. acculturation was significantly related to ART adherence. In conclusion, current, non-syndromic cannabis use did not negatively impact neurocognition or medication adherence in a primarily Latinx sample of PLWH. Rather, current cannabis users and non-users demonstrated similar neurocognitive and adherence outcomes, which suggests that effects of cannabis are innocuous. These are important findings in light of ongoing demographic and socio-political shifts and increased availability of cannabis which promote increased use, particularly among clinical populations such as PLWH. With that said, these relationships remain exceedingly complex and more research is needed. Further, the current findings highlight the need to comprehensively consider sociocultural factors in the assessment, interpretation, and intervention of diverse populations. Doing so will promote culturally-tailored and responsive care, which is necessary for achieving health equity.
Crook, Cara, "The Relationship between Cannabis Use, Neurocognition, and Medication Adherence in a Sample of Latinx and Non-Latinx White People Living with HIV" (2022). ETD Collection for Fordham University. AAI29167806.