Acute Neural and Immune Effects of Alcohol in People Living With HIV Infection

General Inclusion Criteria:

1. 21-60 years old;
2. Able to speak and read English at least at 8th grade level;
3. Alcohol use ≥.60 g/kg at least once in past year. In standard drinks, this amount translates to 1.9-3.0 drinks for an average-weight female and 2.4-3.9 drinks for an average-weight male.
4. Body mass index of 18.5-34.9 kg/m2;
5. Lab tests obtained in past year showing no evidence of acute/chronic Hepatitis B or C infection;
6. HIV-1 serostatus (positive or negative, depending on group) confirmed by standard clinical testing;
7. Able to consume soy and nuts safely (in order to consume the standardized meal).

General Exclusion Criteria:

1. History of heavy drinking on a weekly or more frequent basis, with heavy drinking defined per NIAAA guidelines (≥4 drinks for women, ≥5 drinks for men on a given day), in the past two years;
2. More than five heavy drinking episodes in past 90 days;
3. Seeking or receiving treatment for alcohol/drug use, with exception of smoking cessation treatment;
4. Antibiotic use in past 1 month;
5. Daily use of non-steroidal anti-inflammatory drugs, which are known to increase gut permeability;
6. Disorder of the lower GI tract (e.g., inflammatory bowel disease, ulcerative colitis);
7. Positive urine test for amphetamine, cocaine, methamphetamine, opioids, or benzodiazepines (cannabis use will be assessed but is not an exclusion criterion);
8. Positive screening for past 12-month drug use disorder, indicated by Drug Abuse Screening Test-10 score >2;
9. Current major psychiatric disorder (current major depressive episode, bipolar disorder, psychotic disorder);
10. History of fainting, weakness, infection, excessive bruising, or extreme distress from blood draw;
11. Safety contraindication for MRI (e.g., metal implant); Note: copper intrauterine devices (IUDs) continue to be excluded due to Brown MRI research facility regulations but other non-metal IUDs are allowed;
12. Head trauma with loss of consciousness >10 min;
13. Inability to abstain from nicotine for 8 hours in-session;
14. For cannabis users: inability to abstain for 48 hours prior to study;
15. Pregnant, breastfeeding, or not using effective birth control;
16. Any other clinical condition or therapy that, in the physician's opinion, would make subject unsuitable for study or unable to comply with dosing requirement.

HIV-Specific Inclusion Criteria:

1. On antiretroviral therapy (ART) for ≥6 mos;
2. Labs in past 6 mos showing viral load <100 copies/mL, hemoglobin ≥10.0 g/dL, neutrophil count ≥1,000 cells/μL, and platelet count ≥150,000/μL;
3. No active AIDS diagnosis.