Project Summary/Abstract People living with HIV (PLWH) are seven times more likely to have mild cognitive impairment (MCI) than people without HIV. Women living with HIV (WLWH), and more specifically African American (AA) WLWH, have evidenced poorer cognitive function when compared to their male counterparts living with HIV and women without HIV. Few studies have targeted this population in non-pharmacological strategies to mitigate cognitive impairment. The current proposed study will assess the feasibility and acceptability of mindfulness-based stress reduction (MBSR) in AA WLWH with MCI. MBSR has the potential to reduce stress through self-regulation of attention and awareness to stressful events. MBSR has demonstrated efficacy in improving or stabilizing cognition, improving stress management, psychological distress, physical and psychological symptoms, quality of life, and coping in the general population, as well as ART adherence in PLWH. Yet, the studies have been conducted in predominately white and male patient populations. Thus, the research proposed here will begin to address these gaps by piloting the MBSR intervention for AA WLWH with MCI. This will be an important first step in developing and implementing MBSR protocols in AA WLWH with MCI. In our Supplement Aim we will conduct a two-arm randomized pilot test of the adapted intervention compared to a usual care control group among 30 AA WLWH (15/arm) to assess the feasibility and acceptability of the MBSR among WLWH with MCI. Feasibility will be assessed by our ability to (1) recruit, randomize, and retain participants and (2) deliver the intervention per the manual, as well as (3) participants adherence to home practices and assignments. Acceptability will be assessed via qualitative data (focus group input regarding participants’ satisfaction with the intervention and intent to continue using the practices), as well quantitative data (satisfaction survey). The ultimate goal of this research is to: 1) reduce racial and gender disparities in cognitive impairment and dementia prevalence, 2) inform next steps for efficacy testing and implementation of a group-based non-pharmacologic interventions targeting cognitive outcomes in diverse populations, and 3) impact clinical and public health recommendations for maintaining cognitive health in aging populations.