This forum reviews the evolution of CNS MRI in HIV, from early detection of opportunistic infections to advanced assessment of viral and treatment-related effects, highlighting characteristic imaging findings across different disease stages and patient populations. It examines the role of MR spectroscopy in evaluating basal ganglia metabolite changes in HIV-associated tuberculous meningitis, highlighting its potential to improve understanding of disease severity and outcomes in this high-risk population. Finally, the forum explores how MRI, including structural and diffusion techniques, has advanced understanding of cerebral malaria by characterizing brain injury, identifying imaging markers of severity and fatality, and informing future research and treatment strategies across diverse patient groups.