Patterns of substance use and arrest among hospitalized people living with HIV: A latent class analysis (original) (raw)

Aims: Gender differences in cannabis use and CUD have been established, yet differences in treatment response are not well understood. Though some evidence suggests women fare worse than men, the mechanisms are unclear. The current study aims to identify factors associated with gender differences in cannabis use outcomes. (1) Examine how motivation to change and self-efficacy impact treatment outcomes, and whether gender moderates these relationships. (2) Explore additional clinical correlates that may account for gender differences in cannabis outcomes. Methods: A secondary data analysis of a 12-week double-blind placebo controlled trial of buspirone treatment for cannabis dependent adults (N = 175) was conducted. Self-report assessments of motivation, self-efficacy, and other clinical correlates were completed at baseline, and cannabis use was measured weekly using self-report and urine toxicology. Primary outcomes included point prevalence abstinence and creatinine adjusted cannabinoid levels. Results: There was a significant interaction between gender and SOCRATES-Taking Steps on abstinence (p = .018). Higher taking steps reduced likelihood of achieving abstinence among women (p = .001); there was no association among men. Subsequently, taking steps was positively associated with self-efficacy (p = .006) and quantity of use (p = .000) among men, and cannabis related problems (p = .04) among women. There was a significant interaction between gender and MJ Ladder-Readiness to Change on creatinine adjusted cannabinoid levels (p = .004). Change readiness was positively associated with cannabinoid levels among women (p = .000), but not men. Conclusions: Readiness to change and initiation of change behavior predicts worse cannabis outcomes in women. Men and women differ in what motivates change behavior. Social desirability, neurobiology, and treatment type may impact these effects. Gender differences in cannabis treatment response must be considered in future studies. Financial support: NIDA: T32DA007288 (PI McGinty) R01DA026782, K24DA038240 (PI McRae-Clark).