Alcohol and Cannabis co-use and HIV risk, Treatment and Prevention Outcomes: A Scoping Review
Abstract
Purpose of Review
Alcohol and cannabis are substances commonly used by people with or made vulnerable to HIV. With changing cannabis legalization, cannabis use has been on the rise, including simultaneous use (co-use) with alcohol. Prior reviews have assessed patterns, correlates, and consequences of alcohol and cannabis co-use. We conducted a scoping review to examine alcohol and cannabis co-use and HIV risk, treatment, and prevention outcomes.
Recent Findings
We identified 818 unique articles across seven databases through December 2024, of which, 28 met criteria. There was substantial heterogeneity in the conceptualization of co-use, measurement, and analysis methods. Many studies employed cluster analyses, with alcohol and cannabis co-use often included in the context of polysubstance use. Only one study utilized event-level methods to assess simultaneous use and sex behaviors. Findings on the relationship between alcohol and cannabis co-use and antiretroviral medications (ARV) outcomes and sex behaviors are mixed, though several studies suggest that co-use may be associated with poorer ARV adherence and increased engagement in sex behaviors that increased HIV risks.
Summary
This review highlights substantial heterogeneity in how alcohol and cannabis co-use is conceptualized and measured. Few studies examined simultaneous use specifically or disentangle co-use from broader polysubstance patterns. Research prioritizes standardized and event-level assessment can enhance accuracy of measurement and elucidate contextual factors for alcohol and cannabis co-use. Understanding how alcohol and cannabis co-use affects populations disproportionately impacted by HIV can inform more effective and tailored HIV treatment and prevention strategies.
Keywords
Alcohol · Cannabis · Marijuana · HIV · Co-use · Simultaneous use
Chen, Y., Marziali, M. E., Magana, C., Maxwell, J. A., Chung, T., Huh, J., Pagkas-Bather, J., & Knox, J. (2026). Alcohol and Cannabis co-use and HIV risk, Treatment and Prevention Outcomes: A Scoping Review. Current Addiction Reports, 13(1). https://doi.org/10.1007/s40429-025-00707-x