Marijuana users with HIV infection were more likely to die from AIDS and other conditions than their counterparts without HIV, a new study suggests.

Compared to their counterparts, African-Americans who also used amphetamine were more likely to die of conditions such as cancer and depression, according to a report published in the Journal of the National AIDS Society.”This study suggests that more focus should be placed on prevention of substance use disorder in African-Americans, with effecting reductions of 20-30 percent in Black-American deaths due primarily to drug-related diseases,” said lead researcher Andrea Sacco of the University of Bologna.

HIV prevalence in Mexico, where both HIV and marijuana are prevalent, was 61.5 percent in 2017, up from 56.2 percent in 1995. Latin American immigrants accounted for more than 10 percent of the people with HIV, the study found. But overall, about 19 percent of the population identified as belonging to a racial or ethnic group with HIV.Compared with black Americans who were enrolled in Medicaid but did not have Medicaid eligibility as Medicaid recipients, African-Americans who did have Medicaid were more than two and a half times as likely to develop HIV. In addition, compared with white Americans, African-Americans who were Medicaid recipients were more than four times as likely to develop either tuberculosis or malaria, the report found.

If the study’s findings are replicated by white Americans, “it may be time to act on these differences and develop a prevention strategy that has both a treatment and prevention component, and is culturally competent for both groups and tailored to their needs,” the authors concluded.

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Opioid abuse has risen over the past 20 years in many places around the world, the report noted.”Common contributing factors that increase the risk of opioid abuse include income and education, but not research racism, information overload or lack of incentives,” the study authors wrote.

The same opioid epidemic is also more likely in Latin America, where the percentage of people infected rose to 31 percent from 11 percent a decade ago, the study authors noted.

Opioid abuse has not been studied in Africa, the researchers suggested.”Although the illness has been studied in Africa, it is an understudied and underfunded area,” Sacco said by email. “Our study is an important contribution to the conversation around these epidemics and must be studied more fully, especially since it is not assessed globally.”