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 and verbal 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 or cardiac 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 affect HPA axis cortisol responses.