Grant: Doctoral Research Award: Canada Graduate Scholarships

Cannabis use is markedly elevated among people living with HIV (PLWH), reflecting widespread use of cannabis to manage physical and mental health symptoms in this population. Although many PLWH who use cannabis to manage symptoms do so with medical cannabis authorization (MCA), the 2018 legalization of nonmedical cannabis in Canada has ostensibly diverted some PLWH toward nonmedical cannabis sources given barriers to accessing MCA. Thus, the correlates of MCA may have changed from pre- to post-legalization. The self-medication hypothesis posits that using cannabis to manage symptoms with limited medical supervision could lead to riskier cannabis use patterns, and in turn, greater cannabis-related harms. However, no research has longitudinally examined pre- and post-legalization correlates of MCA, nor the role of self-medication processes in cannabis outcomes among PLWH in a post-legalization context. My doctoral research will help to fill these critical knowledge gaps. Using more than 20 years of longitudinal data from the Ontario HIV Treatment Network Cohort Study, Study 1 will examine the within- and between-person clinical, cannabis-use-related, and sociodemographic correlates of MCA among PLWH who use cannabis to manage symptoms, both pre- and post-legalization. Study 2 will use ecological momentary assessment to collect real-time data on cannabis use in the daily lives of PLWH, from which self-medication processes characterizing cannabis use without MCA among PLWH in the post-legalization environment will be examined. The proposed research will identify how the clinical correlates of using cannabis to manage symptoms with versus without MCA among PLWH have shifted amid a dynamic legal landscape, informing medical cannabis policy. Further, in elucidating the role of self-medication processes in risk for cannabis-related harms, this work can inform interventions that reduce barriers to accessing cannabis-related medical guidance for PLWH.