This study explored relationships between neurocognitive impairment (NCI), engagement in HIV care, and functional disability among sexual minority men aged 50 years or older living with HIV, chronic pain, and recent substance use. Sixty-three participants completed cross-sectional assessments including a neurocognitive screening measure, self-reported HIV medication adherence, past-year attendance at HIV-care appointments, and indices of pain and functional impairment. Mean participant age was 57.2 years
most identified as White (55%), followed by Black/African American (42%). On average, participants reported moderate pain
66.7% met DSM-5 criteria for a substance use disorder. Average Montreal Cognitive Assessment (MoCA) performance reflected mild NCI. Regression analyses indicated an association between poorer MoCA performance and past-year missed HIV-care appointments (