We examined neurocognitive functioning among persons with acute or early HIV infection (AEH) and hypothesized that the neurocognitive performance of AEH individuals would be intermediate between HIV seronegatives (HIVโ) and those with chronic HIV infection. Comprehensive neurocognitive testing was accomplished with 39 AEH, 63 chronically HIV infected, and 38 HIVโ participants. All AEH participants were HIV infected for less than 1ย year. Average domain deficit scores were calculated in seven neurocognitive domains. HIVโ, AEH, and chronically HIV infected groups were ranked from best (rank of 1) to worst (rank of 3) in each domain. All participants received detailed substance use, neuromedical, and psychiatric evaluations and HIV infected persons provided information on antiretroviral treatment and completed laboratory evaluations including plasma and CSF viral loads. A nonparametric test of ordered alternatives (Page test), and the appropriate nonparametric follow-up test, was used to evaluate level of neuropsychological (NP) functioning across and between groups. The median duration of infection for the AEH group was 16ย weeks [interquartile range, IQR: 10.3โ40.7] as compared to 4.9ย years [2.8โ11.1] in the chronic HIV group. A Page test using ranks of average scores in the seven neurocognitive domains showed a significant monotonic trend with the best neurocognitive functioning in the HIVโ group (mean rankโ=โ1.43), intermediate neurocognitive functioning in the AEH group (mean rankโ=โ1.71), and the worst in the chronically HIV infected (mean rankโ=โ2.86; L statisticโ=โ94, pโ<โ0.01); however, post-hoc testing comparing neurocognitive impairment of each group against each of the other groups showed that the chronically infected group was significantly different from both the HIVโ and AEH groups on neurocognitive performance; the AEH group was statistically indistinguishable from the HIVโ group. Regression models among HIV infected participants were unable to identify significant predictors of neurocognitive performance. Neurocognitive functioning was worst among persons with chronic HIV infection. Although a significant monotonic trend existed and patterns of the data suggest the AEH individuals may fall intermediate to HIVโ and chronic participants, we were not able to statistically confirm this hypothesis.