Objective: To examine the effects of anxiety on neuropsychological performance among HIV positive adults in Lusaka, Zambia.Design: A cross-sectional study with a sample of 263 participants of who 107 (40.7%) were males and 156 (59.3%) were females.Measures: The International Neurobehavioural Test Battery and Beck Anxiety Inventory were used to assess cognitive performance and anxiety levels respectively.Results: Severe anxiety showed a weak positive correlation (r=.148, p=0.472), but the result did not reach statistical significance. Participants who were not able to perform instrumental activities of daily living independently were more likely to be anxious (p<0.05).Conclusion: Results obtained from this study imply that there are minimal differences in performance between non anxious and anxious HIV positive individuals on neurocognitive performance. However, anxiety showed an effect on instrumental activities of daily living of the participants.Key Words: Anxiety, HIV, instrumental activities of daily living, Cognitive Performanc