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Both HIV and stimulants are independently associated with deficits in reward\u2010based decision making, but their interactive and\/or additive effects are poorly understood despite their prevalent co\u2010morbidity. Here, we examined the effects of cocaine dependence and HIV infection in 69 adults who underwent functional magnetic resonance imaging while completing an economic loss aversion task. We identified two neural networks that correlated with the evaluation of the favorable characteristics of the gamble (i.e. higher gains\/lower losses: ventromedial prefrontal cortex, anterior cingulate, anterior and posterior precuneus and visual cortex) versus unfavorable characteristics of the gamble (i.e. lower gains\/higher losses: dorsal prefrontal, lateral orbitofrontal, posterior parietal cortex, anterior insula and dorsal caudate). Behaviorally, cocaine and HIV had additive effects on loss aversion scores, with HIV\u2010positive cocaine users being the least loss averse. Cocaine users had greater activation in brain regions that tracked the favorability of gamble characteristics (i.e. increased activation to gains, but decreased activation to losses). In contrast, HIV infection was independently associated with lesser activation in regions that tracked the unfavorability of gamble characteristics. These results suggest that cocaine is associated with an overactive reward\u2010seeking system, while HIV is associated with an underactive cognitive control system. Together, these alterations may leave HIV\u2010positive cocaine users particularly vulnerable to making unfavorable decisions when outcomes are uncertain.<\/jats:p>","DOI":"10.1111\/adb.12529","type":"journal-article","created":{"date-parts":[[2017,7,6]],"date-time":"2017-07-06T10:20:55Z","timestamp":1499336455000},"page":"796-809","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":27,"title":["Cocaine and HIV are independently associated with neural activation in response to gain and loss valuation during economic risky choice"],"prefix":"10.1111","volume":"23","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0864-1123","authenticated-orcid":false,"given":"Christina S.","family":"Meade","sequence":"first","affiliation":[{"name":"Department of Psychiatry and Behavioral Sciences Duke University School of Medicine  Durham NC USA"},{"name":"Duke Global Health Institute  Durham NC USA"},{"name":"Department of Psychology and Neuroscience Duke University  Durham NC USA"},{"name":"Brain Imaging and Analysis Center Duke University Medical Center  Durham NC USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Merideth","family":"Addicott","sequence":"additional","affiliation":[{"name":"Department of Psychiatry and Behavioral Sciences Duke University School of Medicine  Durham NC USA"},{"name":"Brain Imaging and Analysis Center Duke University Medical Center  Durham NC USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3020-3963","authenticated-orcid":false,"given":"Andrea L.","family":"Hobkirk","sequence":"additional","affiliation":[{"name":"Department of Psychiatry and Behavioral Sciences Duke University School of Medicine  Durham NC USA"},{"name":"Duke Global Health Institute  Durham NC USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sheri L.","family":"Towe","sequence":"additional","affiliation":[{"name":"Department of Psychiatry and Behavioral Sciences Duke University School of Medicine  Durham NC USA"},{"name":"Duke Global Health Institute  Durham NC USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nan\u2010Kuei","family":"Chen","sequence":"additional","affiliation":[{"name":"Brain Imaging and Analysis Center Duke University Medical Center  Durham NC USA"},{"name":"Department of Radiology Duke University School of Medicine  Durham NC USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sriramkumar","family":"Sridharan","sequence":"additional","affiliation":[{"name":"Duke Global Health Institute  Durham NC USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Scott A.","family":"Huettel","sequence":"additional","affiliation":[{"name":"Department of Psychology and Neuroscience Duke University  Durham NC USA"},{"name":"Brain Imaging and Analysis Center Duke University Medical Center  Durham NC USA"},{"name":"Center for Cognitive Neuroscience Duke 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