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

General Inclusion Criteria:

• 21-60 years old;
• Able to speak and read English at least at 8th grade level;
• 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.
• Body mass index of 18.5-34.9 kg/m2;
• Lab tests obtained in past year showing no evidence of acute/chronic Hepatitis B or C infection;
• HIV-1 serostatus (positive or negative, depending on group) confirmed by standard clinical testing;
• Able to consume soy and nuts safely (in order to consume the standardized meal).

General Exclusion Criteria:

• 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;
• More than five heavy drinking episodes in past 90 days;
• Seeking or receiving treatment for alcohol/drug use, with exception of smoking cessation treatment;
• Antibiotic use in past 1 month;
• Daily use of non-steroidal anti-inflammatory drugs, which are known to increase gut permeability;
• Disorder of the lower GI tract (e.g., inflammatory bowel disease, ulcerative colitis);
• Positive urine test for amphetamine, cocaine, methamphetamine, opioids, or benzodiazepines (cannabis use will be assessed but is not an exclusion criterion);
• Positive screening for past 12-month drug use disorder, indicated by Drug Abuse Screening Test-10 score >2;
• Current major psychiatric disorder (current major depressive episode, bipolar disorder, psychotic disorder);
• History of fainting, weakness, infection, excessive bruising, or extreme distress from blood draw;
• 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;
• Head trauma with loss of consciousness >10 min;
• Inability to abstain from nicotine for 8 hours in-session;
• For cannabis users: inability to abstain for 48 hours prior to study;
• Pregnant, breastfeeding, or not using effective birth control;
• 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:

• On antiretroviral therapy (ART) for ≥6 mos;
• 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;
• No active AIDS diagnosis.