Background: Our study aimed to understand the effects of HIV and cocaine dependence (CD) on discrete aspects of executive functioning via the Stroop Color-Word Test and the Trail Making Test (TMT). We recruited 101 participants (26 HIV+/CD+; 18 HIV+/CD-; 30 HIV-/CD+; and 27 HIV-/CD-. Methods: We utilized a series of 2 (HIV: yes/no) × 2 (Cocaine: yes/no) ANCOVA’s while controlling for age and premorbid intelligence on the Stroop trials (i.e., color-naming, word reading, interference), and ANOVA’s were used to test for group differences on TMT-A and TMT-B z-scores, the number of errors, and the B/A ratio score. Results: We found a significant main effect of HIV on the Stroop Interference (p = 0.012) and the TMT B/A ratio (p = 0.017), these findings are consistent with difficulties in cognitive flexibility. On the Color-Naming and Interference trials, individuals with CD made significantly more errors than non-users (p = 0.028), demonstrating difficulties with inhibition. Conclusions: Our results show HIV and CD are associated with different underlying cognitive processes which impact overall executive functioning. Understanding the different cognitive factors impacting executive functioning can help formulate tailored treatment recommendations and targeted interventions for people living with HIV and those with cocaine dependence.

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