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Marijuana Use Among People Who Are Pregnant Who Are Living with HIV is Increasing

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Researchers say findings argue for including substance use counseling in family planning care for people living with HIV.

Marijuana use by pregnant people has not been associated with fetal defects, but some evidence suggests that it might affect birth weight and neurodevelopment. The drug is increasingly available through legal channels as a growing number of states — about 20 so far — have moved toward legalizing marijuana for recreational use and a majority have legalized marijuana for medical purposes. For both of these reasons, researchers are beginning to collect data on marijuana use among pregnant people.

People who are pregnant who are living HIV are of special interest, partly because studies have shown that marijuana use among people living with HIV is higher than use in the general population.

Findings reported last week in JAMA Network Open indicate that marijuana use among people who are pregnant who are living with HIV is increasing.

Lynn M. Yee, M.D., M.P.H., of Northwestern University’s Feinberg School of Medicine, and her colleagues, reported that between 2007 and 2019, the prevalence of marijuana use among pregnant people living with HIV increased from 7.1% in 2007 to 11.7%. During that same period, the prevalence of alcohol use and opioid use among people who are pregnant remained the same.

Yee and her colleagues also found that marijuana use in the postpartum use also increased, from 10.2% in 2007 to 23.7% in 2019.

Their findings were based data from 2,926 pregnancies among 2,310 people living with HIV who were enrolled in the Surveillance Monitoring for Antiretroviral Toxicities (SMARTT) study at 22 sites in the United States. Substance use was assessed through self-reporting. The researchers noted that self-reporting may paint a picture of prevalence of substance use that is lower than the actual one because people may be uncomfortable volunteering that they are using substances.

One policy implication of the research findings might be to include substance use counseling in family planning for people with HIV. Family planning is critical for people with HIV because of the importance of optimizing antiretroviral therapy before conception.

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