Abstract
INTRODUCTION: Past research has shown that inflammation is reduced among marijuana-using HIV-negative people but not those living with HIV. We take this work a step further by assessing differences based on pre-exposure prophylaxis (PrEP) use among HIV-negative individuals. METHODS: National Couple's Health and Time is a nationally representative cohort study of 3642 adult respondents who are married or cohabiting. Their ages range from 20 to 60 years with 45% self-identifying as nonheterosexual. Biologic data (n = 573; C-reactive protein [CRP], interleukin-6 [IL-6], and Epstein Barr virus [EBV] antibody levels) were collected through finger stick dried blood spots as part of National Couple's Health and Time-BIO, a substudy. Participants self-reported demographic characteristics, PrEP use, and marijuana use. Multivariable regression analyses were used to assess the relationship between these variables and each of the measured biomarkers, adjusting for known confounders. RESULTS: In adjusted models, neither lifetime nor current PrEP use was associated with CRP, IL-6, or EBV antibody levels. Moreover, marijuana use did not differ among those who used PrEP versus those who did not. Among PrEP users, those who reported marijuana use had lower CRP than those who did not (B = -2.31; 95% CI: -4.23 to -0.40). Among non-PrEP users, no association was observed between marijuana use and CRP. CONCLUSIONS: The current preliminary data suggest inflammation is reduced among PrEP users who also use marijuana, but the same is not true among non-PrEP users. These findings may suggest that PrEP increases inflammation that is then partially mitigated by the individual cannabinoids or cannabidiols found in marijuana, although more research is needed to confirm this hypothesis.