Cedra Ali, a senior Honors student in the Department of Psychology and Neuroscience, presented her research at the 4th Annual Global Health Scholars Symposium in February. She was the only undergraduate presenter at the event, which primarily featured doctoral trainees, postdoctoral fellows, and faculty researchers from all over the globe. Her project examined the prevalence and impact of migraine disorders among HIV-positive adults in Peru—an understudied area that may inform more comprehensive and equitable neurological care.
Getting Started in Research
Seeking meaningful research experience in clinical neurology and patient-centered care, Ali connected in October 2024 with Dr. Monica Diaz, a global health neurologist and investigator with the Institute for Global Health and Infectious Diseases. Diaz was leading a multidisciplinary study in Peru aimed at improving identification of HIV-associated neurocognitive disorder (HAND).
After learning about the project, Ali identified an opportunity to expand the study’s neurological scope. She proposed adding a migraine screening and analysis component to examine potential links between headache disorders and neurocognitive outcomes in people living with HIV—an area that remains largely unexplored in neurological research in Latin America.
Ali formalized her work through NSCI 395: Undergraduate Research and was mentored in the department by Dr. Sylvia Fitting, whose research focuses on HIV-related neurobiology.
“I was interested in understanding how HIV affects neurological health beyond the conditions that are most commonly studied,” Ali said. “Migraine exists at the intersection of neurological, immunological, and mental health processes, yet it is rarely examined within the broader clinical context of HIV, particularly in underrepresented populations.”
Designing the Study
Research suggests people living with HIV experience more frequent and severe headaches, yet data remain limited—especially in Latin America. Ali analyzed 81 HIV-positive adults, including 34 who completed a detailed headache questionnaire.
The study evaluated demographic, clinical, and behavioral variables such as age, CD4 nadir, HIV duration, depression, anxiety, and comorbid conditions. Headache characteristics—including intensity, frequency, associated symptoms, and functional impact—were classified using International Classification of Headache Disorders (ICHD-3) criteria. Ali also compared participants whose headaches began before versus after HIV diagnosis to explore temporal associations.
By combining clinical testing with self-reported data, the study provides preliminary insight into how migraines manifest in people living with HIV and how they may relate to neurocognitive outcomes.
“Through mentorship from Dr. Diaz and Dr. Fitting, I gained experience in clinical data analysis, epidemiologic study design, and applying international diagnostic criteria,” Ali said.
The findings contribute early data to an emerging area of global neurology: understanding the burden and characteristics of headache disorders among people living with HIV in Latin America. This work may help inform future diagnostic and treatment approaches, particularly in resource-limited settings.
Personal Motivation
Ali’s interest in neurology is both academic and personal. Having lived with chronic migraines and with a family history of Parkinson’s disease, she developed an early awareness of how neurological conditions can shape daily life and long-term well-being. These experiences have fueled her commitment to advancing neurological care, particularly for underserved populations.
“These experiences shaped how I think about medicine,” she said. “Neurological conditions don’t just affect the brain — they affect identity, independence, and quality of life. I’m especially drawn to understanding how these conditions impact people who may already face barriers to care.”
Ali plans to attend medical school and pursue a career as a neurologist. Throughout her undergraduate education, she has intentionally built a foundation and applied herself to rigorous pre-medical coursework, clinical experience, and global health research. “This project is incredibly meaningful to me,” she said. “It brings together my interest in global health, patient-centered research, and my own experience with chronic migraine.”
Her global health engagement extends beyond Peru. In 2025, she participated in a study abroad research program in Thailand, working with an HIV-focused community health center serving LGBTQ+ populations—an experience that deepened her understanding of how neurological and infectious diseases intersect with culture, access to care, and health equity around the world.
Future Directions
The next phase of the project will analyze an expanded dataset that includes HIV-negative participants, enabling comparative analysis. Ali and her team plan to submit their findings to a peer-reviewed journal.
Her work highlights the importance of inclusive, globally representative neurological research. As she continues to build on this project, Ali aims to pursue a medical career that integrates neurology, research, and global health, with the goal of advancing equitable care for historically underrepresented populations.