Equity in HIV mental health research:a call to action

The brain remains a key reservoir of latent HIV infection, and people living with HIV (PLWH) face a high risk for cognitive impairment and psychiatric disorders. Although the burden of HIV infection and co-morbidities is greatest in the Global South, a large proportion of HIV mental health research is carried out in the Global North. Large, well-funded observational cohort studies exploring HIV-associated psychopathology generally involve participant groups from WEIRD (Western, educated, industrialised, rich and democratic) settings. The socioeconomic status and institutional access afforded to these participant groups on average does not reflect those of the majority of beneficiaries of HIV mental health research. This misalignment may lead to limitations in generalising findings and developing effective interventions to improve the mental health of PLWH. Here, I offer recommendations to actively cultivate authentic diversity and inclusion in the field, with four focus points: (1) for funding bodies, to actively invest in neuroscientists in the Global South for investigations of HIV-related psychopathology; (2) for scientific publishers, to fund professional support services for researchers in the Global South; (3) for academic institutions, to facilitate meaningful, equitable collaborations with researchers in the Global South and incentivise studies with diverse participant groups; and (4) for individual neuroscientists, to actively cite and converse with colleagues in the Global South, tackle personal biases in those conversations, and avoid overgeneralising findings from primarily WEIRD participant groups

Teaching English, 'Changing Lives': The British Council and the Neoliberal Preservation of British Imperialism

This article critically analyses the modern function of the British Council, which operates as a primarily educational organisation in many formerly-colonised nations such as India and Pakistan. Here, I argue that the ways in which the British Council aims to spread British culture around the globe is a direct continuation of British imperial policies and furthers the harmful historical erasure that allows imperialism to persist today

The Collective Unconscious of Rome and India: Narrative Archetypes in the Abduction of Proserpina of Ovid’s Metamorphoses and Sita of the Ramayan

The Ramayan, a seminal South Asian mythological text, is rarely examined in scholarship concerning ancient literary texts, in part due to the overwhelming focus on the Greco-Roman canon. Ovid’s Metamorphoses has long served as a window into Greco-Roman culture and mythology. However, the ways in which the Metamorphoses may be shaped by, and in turn shape, the interactions between myths and cultures beyond the Greco-Roman world is underexplored. This article highlights stark narrative parallels between the abduction of Proserpina in the Metamorphoses and the abduction of Sita in the Ramayan. Given that these texts are genetically and geographically distinct, tracing the origin of these parallels remains challenging. Here, I leverage a Jungian analytical framework to propose that “narrative archetypes” – collections of images stored in the collective unconscious which manifest in myths across cultures – may explain why episodic details are conserved between the Metamorphoses and the Ramayan

isiXhosa Translation of the Patient Health Questionnaire (PHQ-9):A Pilot Study of Psychometric Properties [Stage 1]

Depression is a debilitating illness, and stigma associated with it often prevents people from seeking support. Easy-to-administer and culturally-specific diagnostic tools can allow for early screening for depression in primary care clinics, especially in resource-limited settings. In this pilot study, we will produce the first open-access isiXhosa-language version of the nine-item Patient Health Questionnaire (PHQ-9), a well-validated measure of depression incidence and severity, using a transcultural translation framework. We will validate this isiXhosa PHQ-9 in a small sample of adolescents living with HIV in Cape Town, South Africa who speak isiXhosa at home. Participants have previously completed the ASEBA Youth Self Report (YSR) form, and responses from the YSR will be used as a gold standard to validate the isiXhosa PHQ-9. If validated through this Registered Report, this isiXhosa PHQ-9 may be an invaluable culturally-specific tool for clinicians serving Xhosa people in identifying clinical or sub-clinical depression

Neuroinflammation and mental health outcomes in adolescents living with HIV

PURPOSE OF REVIEW: Adolescents living with HIV show chronic inflammation, which in turn has been linked to mental health outcomes in the general population. The increased risk for mental health issues in adolescents with HIV may thus be driven by HIV-related inflammation. In this review, we discuss the associations between peripheral and central nervous system inflammation and mental health outcomes in adolescents with HIV.RECENT FINDINGS: Preclinical models indicate that expression of HIV viral proteins early in life may lead to neuroinflammation and behavioural deficits in adolescence. Clinical evidence is available primarily in the general population and in adults with HIV, and suggests that inflammatory biomarkers such as IL-6 and TNF-α may be associated with depressive symptoms. Only one study has explored these relationships in adolescents with HIV, and did not find that inflammatory biomarkers in the blood or brain were linked to depressive symptoms. Current research in this field focuses overwhelmingly on peripheral inflammatory biomarkers (compared to neuroimaging biomarkers) and on depression (compared to other mental health conditions).SUMMARY: There is strong evidence to suggest that neuroinflammation and peripheral inflammation may play a role in the development of mental health issues in adolescents, but research in adolescents with HIV is sparse. Characterizing the relationship between inflammation and mental health in adolescents with HIV may help improve the prediction, prevention, early intervention, and treatment of mental health issues in this population.<br/

Taking lead from the community: What do young people living with HIV want us to research?

Priority setting workshops enable researchers to take the lead from people with relevant lived experience, and design research which authentically responds to community needs. Large-scale global priority setting exercises have previously identified key research questions related to paediatric and adolescent HIV treatment, prevention, and service delivery. However, priority setting workshops focused on the needs of young people living with HIV are lacking in southern Africa. Here, we report the outcome of a priority setting workshop organised in Cape Town, South Africa with 19 young people living with HIV and their parents and caregivers. Workshops were facilitated by trained research and clinical staff, who provided a plain-language introduction to research questions for the attendees. During the day-long workshop, attendees developed a list of research questions concerning HIV-related physical health, mental health, and psychosocial support and later voted on the order of importance for the questions which they had collectively identified. Facilitators did not prompt any questions or amend the phrasing of questions generated by the attendees. A cure for HIV was highlighted as the most important research priority for young people living with HIV. Other priorities for young people included the effects of antiretroviral therapy on the body, the brain, and their social relationships, causes of emotional issues such as depression and mood swings, and potential interventions to reduce HIV-related stigma in schools through positive education for teachers and students. Research priorities for parents and caregivers included improving antiretroviral adherence through long-acting injections, mental health impacts of HIV status disclosure without consent, and improving support provided by local community clinics. The research questions identified through this workshop may be used by researchers to develop future studies which truly benefit young people living with HIV in South Africa and beyond