Cognitive impairment is an important comorbidity for people aging with HIV, and group therapy may ameliorate the associated anxiety and stress. Combination psychosocial interventions may have better outcomes than single technique approaches. A pilot, parallel design, two-arm trial randomized people aging with HIV-Associated Neurocognitive Disorder (HAND) to Cognitive Remediation Group Therapy (Experimental; combination of brain training activities and mindfulness-based stress reduction) or Mutual Aid Group Therapy (Control). Outcomes were feasibility, acceptability, fidelity, and exploratory measures of anxiety, stress, coping, and use of mindfulness and brain training activities. Amongst forty contacted participants, 15 replied, 12 recruited, and 10 completed. Assessors confirmed intervention delivery with satisfactory fidelity. The novel arm had statistically significant improvements in stress and mindfulness use compared to control, and brain training and mindfulness use sustained at 3-month follow-up. Requiring a HAND diagnosis made recruitment challenging. Further research should broaden eligibility to people aging with HIV and cognitive challenges.