Cannabis and Tinnitus in People with and without HIV

The relationship between cannabis use and tinnitus is unclear, particularly among people with HIV. The relationship between cannabis use and tinnitus prevalence and its severity in the MACS/WIHS Combined Cohort Study (MWCCS) was examined.

Cross-sectional data collected between October 1, 2020, and September 30, 2022, were drawn from the MWCCS. Tinnitus was defined as bothersome ringing, roaring, or buzzing in the ears or head that lasted for 5 minutes or more in the past 12 months. Tinnitus severity (among those reporting tinnitus) was dichotomized as no/small problem versus moderate to very big problem. Cannabis use was self-reported as the frequency of use in the past six months. Modified Poisson regression models were used to estimate associations adjusted for age, sex, race/ethnicity, HIV status, loud noise exposure, self-rated hearing, smoking, depression, as well as HIV viral load suppression and years of nucleoside reverse transcriptase inhibitors medication use (only for those with HIV).

Among 3,437 participants (mean age=55; 55% female; 63% PWH), 31% reported cannabis use and 16% reported tinnitus. There was no statistically significant association between cannabis use and tinnitus prevalence. However, any cannabis use was significantly associated with a 29% lower prevalence of reporting moderate-to-severe tinnitus severity (aPR=0.71; 95% CI: 0.54–0.94). Stratified analyses also showed that any cannabis use was associated with a lower prevalence of reporting moderate-to-severe tinnitus severity (aPR=0.58; 95% CI: 0.37–0.90) among persons without HIV.

Cannabis use was not associated with tinnitus prevalence but was associated with lower perceived tinnitus severity, particularly among participants without HIV. These findings suggest that cannabis may influence the subjective burden of tinnitus rather than its occurrence, although the underlying mechanisms remain unclear and may involve factors such as symptom perception or coping.

In this large cohort, cannabis use was not associated with the presence of tinnitus but was associated with lower reported tinnitus severity. Given the cross-sectional design and potential for residual confounding, these findings should be considered hypothesis-generating and warrant confirmation in longitudinal studies.