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Zachary L Mannes,1 Larry E Burrell II,1 Erin G Ferguson,1 Zhi Zhou,2,3 Huiyin Lu,4,5 Charurut Somboonwit,6 Robert L Cook,2,3 Nicole Ennis1 1Department of Clinical and Health Psychology, College of Public Health and Health Professions, University of Florida, Gainesville, FL, USA; 2Department of Epidemiology, College of Public Health and Health Professions, 3Department of Epidemiology, College of Medicine, University of Florida, Gainesville, FL, USA; 4Department of Biostatistics, College of Public Health and Health Professions, 5Department of Biostatistics, College of Medicine, University of Florida, Gainesville, Florida, USA; 6Department of Internal Medicine, Morsani College of Medicine, University of South Florida, Tampa, FL, USA Purpose: Marijuana use is common among people living with HIV (PLWH), but its association with antiretroviral therapy (ART) adherence is unclear. This study examined the association between reason for marijuana use and ART adherence in a sample of adults living with HIV. Patients and methods: Participants (N=703) recruited from seven community health centers in Florida completed a 45-minute questionnaire assessing demographics, symptoms of anxiety and depression, ART adherence, and substance use, including reasons for marijuana use. ART adherence was defined as the proportion of days in the last 30 days participants did not miss any medication and dichotomized as optimal (≥95%) and suboptimal (