Neighborhood-level and individual-level correlates of cannabis use among young persons living with HIV/AIDS

Abstract

IntroductionIn addition to individual characteristics, there may be a wide range of environmental or neighborhood stressors that contribute to elevated cannabis use in groups of youth living with HIV/AIDS (YLHIV); however, the effects of social disorganization on cannabis use in YLHIV to date have not been studied. MethodsWe examined the effects of individual-level and neighborhood-level factors by developing hierarchical generalized linear models estimating odds of current cannabis use (any use during the past 3 months) and daily cannabis use among a sample of YLHIV (N=1921) currently receiving medical care. ResultsThe final model for daily cannabis use in the past 3 months included significant positive effects associated with hostility (O.R.=1.08, 95% C.I.: 1.05, 1.11), being older (O.R.=1.12, 95% C.I.: 1.05, 1.20), being a bisexual male (O.R.=1.72, 95% C.I.: 1.10, 2.70), and residing in a community with a murder rate in the highest quartile (O.R.=1.91, 95% C.I.: 1.27, 2.87), second highest quartile (O.R.=1.62, 95% C.I.: 1.06, 2.46), or third highest quartile (O.R.=1.52, 95% C.I.: 1.01, 2.30). DiscussionThis paper advances our knowledge of the multilevel factors associated with elevated cannabis use among groups of YLHIV and furthers our understanding of social and structural determinants of health in this population. Future research into cannabis use among YLHIV should consider, not only cannabis use within the context of the adjustment of living with HIV/AIDS, but also the stressors that characterize the environments in which groups of YLHIV live.