ABSTRACT: Many adults with HIV often have physical and neuropsychiatric challenges that may interfere with their ability to work and earn a living. Others may stop working to reduce job-related stress, hoping this will improve their health. Yet, cognitive stimulation from engagement in employment may exert neuroprotective effects on one’s cognitive reserve and cognitive health, which may facilitate successful cognitive aging. This point is particularly germane given that: (1) by 2020 nearly 70% of adults with HIV will be 50 and older, (2) over half of adults with HIV experience HIV-Associated Neurocognitive Disorders, and (3) only 20% of adults with HIV are continuously employed full-time. This article describes several ways in which employment can be neuroprotective of cognitive reserve and cognitive functioning as it relates specifically to adults with HIV. Implications for practice and research are provided, especially as this premise may also be applicable to other clinical populations.