We develop a stochastic human immunodeficiency virus type 1 (HIV-1) infection model to analyze combination antiretroviral therapy (cART) dynamics in the
brain microenvironment, explicitly accounting for two infected cell states: (1) productively infected and (2) latently infected populations. The model introduces two key
epidemiological thresholds $–\overline{\mathcal{R}}_{c1}$ (productive infection) and $\overline{\mathcal{R}}_{c2}$ (latent infection) –
and defines the stochastic control reproduction number as $\overline{\mathcal{R}}_c={\rm max} \{\overline{\mathcal{R}}_{c1},\overline{\mathcal{R}}_{c2}\}.$ Our
analysis reveals three distinct dynamical regimes: (1) viral extinction $(\overline{\mathcal{R}}_c <1):$ the infection clears exponentially with probability one; (2) latent reservoir dominance $(\overline{\mathcal{R}}_c=\overline{\mathcal{R}}_{c2}>1):$ the system almost surely converges to a purely latent state, characterizing
stable viral reservoir formation; (3) persistent productive infection $(\overline{\mathcal{R}}_c =\overline{\mathcal{R}}_{c1} >1):$ the
infection persists indefinitely with a unique stationary distribution, for which we derive the exact probability density function. And numerical simulations validate these
theoretical predictions, demonstrating how environmental noise critically modulates
HIV-1 dynamics in neural reservoirs. Our results quantify the stochastic balance between productive infection, latency establishment, and cART efficacy, offering mechanistic insights into viral persistence in the brain.