Stress and Pain in People Living With HIV

Inclusion Criteria:

• good health as verified by screening examination

• Able to read English and complete study evaluations and provide informed written andverbal consent. Additional criteria PLWH

• HIV-1 lab test positive

• undetectable viral load

• good ART adherence

Additional criteria by group:

PLWH +CM:

• CB positive urine toxicology

• meet DSM-5 criteria for CUD and MDD as assessed using SCID-I. HC

• HIV-1 test negative

• urine toxicology negative

• no major medical and psychiatric diagnoses based on DSM-V.

PLWH Only:

• HIV-1 test positive

• urine toxicology negative

• no major medical and psychiatric diagnoses based on DSM-V.

CM Only:

• HIV-1 test negative

• urine toxicology positive

• meet DSM-5 criteria for CUD and MDD as assessed using SCID-I

Exclusion Criteria:

• meet primary, current moderate and severe criteria for other SUD including cocaine,alcohol, opiates, sedatives, nicotine

• current use or past history of cocaine or opioid use disorder

• history of any psychotic disorder

• current diagnoses of bipolar disorder and PTSD

• psychotic or otherwise severely psychiatrically disabled (i.e., suicidal, homicidal,current mania)

• significant underlying medical conditions such as cerebral, renal, thyroid orcardiac pathology that would interfere with study participation

• medications with known central effects on HPA axis and cytokines/immune function

• women who are pregnant, nursing or those using hormonal birth control that affectHPA axis cortisol responses.