The global challenge of HIV/AIDS remains one of the most pressing public health issues today. According to the latest data from UNAIDS, around 38.4 million people worldwide are living with HIV/AIDS, underlining the need for not only medical intervention but also comprehensive awareness, education, and social change. Despite the significant strides made in treatment and prevention, the confusion surrounding the relationship between HIV and AIDS still persists.

Young people have become influential advocates in the fight against HIV/AIDS. Research from UNICEF shows that youth-led initiatives can lower HIV transmission rates by as much as 45% in targeted communities. These young activists utilize digital platforms and peer-to-peer education to dispel myths, promote safe practices, and foster supportive environments for those affected by HIV/AIDS.

Dr Gowri Kulkarni, an expert in Internal Medicine, explains that while the terms HIV and AIDS are often used interchangeably, they are distinctly different. "HIV (Human Immunodeficiency Virus) is a virus that attacks the immune system, whereas AIDS (Acquired Immunodeficiency Syndrome) is a condition that occurs when HIV severely damages the immune system," she clarifies. To understand the implications of these differences, it's important to explore the fundamental distinctions between the two.

1. HIV is a Virus; AIDS is a Syndrome

HIV is the virus responsible for attacking the body’s immune system, specifically targeting CD4 cells, which are crucial for the body’s defense against infections. As HIV progresses, it destroys these cells, weakening the immune system over time. If left untreated, this continuous damage can lead to AIDS.

AIDS, on the other hand, is a syndrome, not a virus. Dr Kulkarni further elaborates that AIDS is a collection of symptoms and illnesses that emerge when the immune system is severely compromised due to prolonged HIV infection. It represents the most advanced stage of HIV, and is characterized by very low CD4 counts or the onset of opportunistic infections like tuberculosis, pneumonia, or certain cancers.

2. Not Everyone with HIV Develops AIDS

A key distinction to remember is that not everyone with HIV will progress to AIDS. Thanks to advancements in medicine, particularly antiretroviral therapy (ART), individuals living with HIV can manage the virus and maintain a healthy immune system for many years, or even decades, without ever developing AIDS. ART works by suppressing the virus to undetectable levels, effectively preventing the damage HIV would otherwise cause to the immune system.

Without treatment, however, HIV progresses through three stages:

- Acute HIV Infection: This stage occurs shortly after transmission and may include symptoms like fever, fatigue, and swollen lymph nodes.

- Chronic HIV Infection: Often asymptomatic or mildly symptomatic, the virus continues to damage the immune system but at a slower rate.

- AIDS: This is the final stage, marked by severe immune damage and the presence of infections that take advantage of the compromised immune defenses.

3. HIV is Transmissible; AIDS is Not

Another key distinction between HIV and AIDS is the way in which they are transmitted. HIV is highly contagious and can be transmitted through the exchange of bodily fluids such as blood, semen, vaginal fluids, and breast milk. It is primarily spread through unprotected sexual contact, sharing needles, or from mother to child during childbirth or breastfeeding.

AIDS, however, is not transmissible. It is not a disease that can be passed from one person to another. Rather, AIDS is the result of untreated, advanced HIV infection and is a direct consequence of the virus’s damage to the immune system.

4. Diagnosis Methods Differ

HIV and AIDS are diagnosed through different methods. HIV is diagnosed through blood tests or oral swabs that detect the presence of the virus or antibodies produced by the immune system in response to the virus. Early detection of HIV is crucial, as it allows for timely intervention and treatment, which can prevent the virus from progressing to AIDS.

AIDS, on the other hand, is diagnosed using more specific criteria. Dr Kulkarni notes that the diagnosis of AIDS is made when the individual’s CD4 cell count falls below 200 cells/mm³, or when opportunistic infections or certain cancers (such as Kaposi's sarcoma or lymphoma) are detected. Diagnosing AIDS involves a more thorough assessment of the individual’s immune function and overall health, as opposed to just the detection of HIV.

5. Treatment Goals Are Different

The treatment goals for HIV and AIDS differ significantly, although both involve antiretroviral therapy (ART). For HIV, the primary treatment goal is to suppress the virus to undetectable levels, thus maintaining a strong immune system and preventing further transmission of the virus. People living with HIV can often live long, healthy lives if they adhere to ART.

For individuals diagnosed with AIDS, the treatment plan becomes more complex. While ART remains an essential part of managing the virus, treatment for AIDS also focuses on addressing the opportunistic infections and secondary health complications associated with severe immune suppression. The goal of treatment for AIDS is not only to manage the HIV virus but also to improve the quality of life and extend survival by treating these secondary health issues.

Role of Community Engagement in Combatting HIV/AIDS

While the medical community has made great strides in managing HIV, the battle to curb its transmission is also a social and cultural issue. Dr Daman Ahuja, a public health expert, highlights that HIV/AIDS awareness and education are vital to reducing transmission rates and supporting those affected by the virus. "Young people, especially, have become key advocates in the fight against HIV/AIDS," says Dr Ahuja. "Research from UNICEF shows that youth-led initiatives can lower HIV transmission rates by as much as 45% in targeted communities."

Additionally, grassroots activism plays a significant role in raising awareness and addressing stigma. As the World Health Organization reports, community-based interventions have been proven to increase HIV testing rates and improve treatment adherence, which are crucial in the fight against the pandemic.

The ultimate goal of organizations like UNAIDS is to eliminate the HIV/AIDS pandemic by 2030. Achieving this requires global collaboration, from medical treatment advancements to public health strategies, education, and advocacy. Dr Kulkarni’s insight underscores the importance of early detection, treatment adherence, and community support in the fight against HIV/AIDS.

Dr Gowri Kulkarni is Head of Medical Operations at MediBuddy and Dr Daman Ahuja, a public health expert and has been associated with Red Ribbon Express Project of NACO between 2007-12.

Last week, the Royal Pharmaceutical Society (RPS) advised the public to not use nasal decongestant for more than seven days. The guidelines said that it contains xylometazoline or oxymetazoline. Prolonged use of which could cause 'rebound congestion' or increase dependency on these sprays to breathe easily.

Recently, with the flu cases rising, flu-like symptoms, including nose congestion too have gone up. It is because of this reason, many are using nasal spray continuously, which could cause rebound congestion.

To understand this better, Health and Me spoke to Dr Pranita Bauskar, ENT, Apollo Spectra, Pune.

What Did The Doctor Say About Nasal Spray Usage?

Nasal sprays are widely used by many people to relieve a blocked or stuffy nose caused by colds or allergies. Dr Bauskar explained, "These nasal sprays are known to provide immediate relief. Using decongestant nasal sprays for more than 5 to 7 days could worsen the congestion and steal the piece of mind."

Read: Nasal Spray Warning Over 'Rebound Congestion'; Experts Say It Should Not Be Used For More Than 7 Days

What Does Rebound Congestion Mean?

Doctor says that as the nose becomes more blocked once the medication wears off, this creates a cycle of dependency. "Hence, it is necessary to limit the use of decongestant sprays to a few days only."

What Can Be Used Instead?

Dr Bauskar says, "you can try safer alternatives such as saline nasal sprays or rinses to keep nasal passages moist." Furthermore, the doctor suggests to not to forget to take steam "at least two times a day". "Doing so will help to ease congestion. Ensure to take warm showers, and you will feel better," noted Dr Bauskar.

It is imperative to have allergy medications like antihistamines if allergies persist, as prescribed by the doctor, noted the doctor.

"Everyone is also advised to stay hydrated by drinking enough water and liquids. Try to use a humidifier at home. If a person has congestion for over a week and is unable to breathe ,then don’t rely on nasal sprays and consult the doctor to rule out infections or other underlying problems," said Dr Bauskar.

Is Rebound Congestion Preventable?

It is a preventable condition, and is scientifically known as rhinitis medicamentosa, which causes the symptoms to worsen. Patients become depended on the sprays to breathe more easily.

RPS survey of 300 pharmacists found that 59% think the public is not aware of the risks, while 75% said packaging should be clearer about the seven-day limit. 63% said they had intervened in cases of suspected overuse.

Professor Amira Guirguis, chief scientist at RPS told the ITV News, "Nasal decongestant sprays can be helpful for short-term relief, but using them for longer than seven days can make your congestion significantly worse. Our research shows that many people are unaware of this risk, which means they may continue using these sprays without realizing they could be prolonging their symptoms. We'd like to see clearer warnings on the packaging which you can't miss and greater awareness of the seven-day limit. If your congestion lasts more than a week, speak to your pharmacist. There are safe and effective alternative options to help you manage your symptoms."

Another survey by ITV News suggests that more than a fifth of adults have used the products for longer than seven days. This means 5.5 million people in the UK may have risked developing a dependency.

A one-year-old baby from Uzbekistan rom suffering from a rare genetic liver disorder and was saved by his father who donated a part of his liver. The child was suffering with Alagille syndrome. The timely intervention of the doctors as well as father stepping in saved the child from a life-threatening disease.

What Happened to The Child?

Right after birth the child got jaundice, while it is common for newborns, and appears two to three days after birth, it often resolves in one to two weeks. However, this was not the case with him. The baby required neonatal intensive care. When he was of just two months, he was diagnosed with biliary atresia, a condition that blocks the normal flow of bile from liver. The baby underwent a Kasai procedure, which is a surgery performed in infancy to help restore bile flow.

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However, his condition continued to worsen. The baby suffered from persistent jaundice, severe itching, poor weight gain, delayed growth and pale stools. All of these symptoms indicated progressive liver failure.

This is when the family sought help from specialized liver care in India. Upon a careful assessment, a serious heart ailment too was detected in the baby. The investigation confirmed that the baby had Alagille syndrome.

What Happens In Alagille Syndrome?

As per the National Institute of Health, Alagille syndrome is a multisystem autosomal dominant disorder with a wide variety of clinical manifestation. Johns Hopkins Medicine says it is an inherited condition in which bile builds up in the liver because there are too few bile ducts to drain the bile. This causes liver damage.

This is caused by JAG1 gene mutation and could be passed from parent to child. If the child has one parent with Alagille syndrome, the child has 50% chance of developing the condition. Its rarity makes it appear in one out of 70,000 babies.

Upon the case review, it was identified that only a liver transplant could save the child's life, this is when his father stepped in.

What Does The Expert Say?

Dr Ajitabh Srivastava, Director HPB Surgery and Liver Transplant, Max Super Speciality Hospital, Patparganj, whose team led the transplant said, "“Infants with prolonged jaundice are commonly evaluated for biliary atresia, for which the Kasai procedure is an early surgical treatment aimed at restoring bile flow and delaying the need for liver transplantation." However, he noted, rare conditions like Alagille syndrome could also mimic biliary atresia in early infancy.

"In such cases, the Kasai procedure may not provide lasting benefit because the underlying problem is genetic rather than structural and in fact the wrong procedure (Kasai) worsens the condition of the child. As the liver disease progressed despite early surgery, a timely living donor liver transplant became the only life-saving option," the doctor explains.

The transplant has been successful, noted Dr Srivastava, and the child is on a "steady path to recovery". The doctor especially pointed out how early diagnoses could save lives even from the rarest of the rare diseases.

Air quality has long been linked to lung and heart diseases, but its role in infertility among both women and men often goes unnoticed. In recent years, researchers have begun to better understand how long-term exposure to high levels of air pollution, especially in Indian cities, may harm fertility and reproductive health. Prolonged exposure can damage reproductive cells, interfere with hormone balance, and increase the risk of pregnancy-related complications. While pollution is not the sole cause of infertility, it adds to existing reproductive challenges and can worsen underlying problems.

We got in touch with Dr. Suchithra Reddy, Senior Consultant - Infertility Specialist, Rainbow Children’s Hospital, Sarjapur Road who helped us know more about the same.

Impact of Air Pollution on Male Reproductive Health

Male reproductive health appears to be particularly affected by sustained exposure to polluted air. Fine particulate matter, especially PM2.5, has been closely associated with lower sperm count, reduced motility, abnormal sperm shape, and increased DNA damage in sperm cells. Dr Reddy said, “These changes are largely driven by oxidative stress and chronic inflammation, which directly affect the seminiferous tubules where sperm are produced. In addition, heavy metals present in polluted air may disrupt testosterone levels, a hormone essential for proper sperm development and maturation.”

Effects of Air Pollution on Female Fertility

Air pollution can also negatively influence female fertility. A broad review of existing studies shows that exposure to common air pollutants around the time of conception can reduce the chances of successful pregnancy and raise the risk of miscarriage. Dr Reddy said, “Pollutants frequently found in urban environments, such as PM2.5, nitrogen dioxide, and polycyclic aromatic hydrocarbons, have been shown to impair ovarian function and interfere with embryo implantation.”

Beyond conception, polluted air is linked to a higher likelihood of pregnancy complications, including preterm birth and low birth weight. This is thought to occur because pollutants can limit the supply of oxygen and nutrients to the developing fetus, leading to adverse outcomes.

Hormonal Disruption Caused by Air Pollution

Studies have shown that air pollution exposure can disturb estrogen and progesterone levels and alter hormones involved in ovulation, such as FSH and LH. These changes may result in reduced ovarian function, poorer egg quality, irregular menstrual cycles, and a higher risk of miscarriage. Together, these disruptions directly affect ovulation, implantation, and early pregnancy health.

A significant portion of pollution-related fertility issues is driven by chronic inflammation and oxidative stress. Breathing in polluted air triggers widespread inflammatory responses that can damage hormone-producing organs like the ovaries, testes, and thyroid. It can also interfere with hormone receptors and disrupt communication between the brain and the endocrine system. These internal changes contribute to hormonal imbalance and impaired reproductive function. The severity of these effects varies, and not everyone exposed to pollution will experience fertility or hormonal problems.

Understanding PM2.5 and PM10 Exposure

Not all particulate matter carries the same level of risk. PM10 consists of larger particles that are often trapped in the upper respiratory tract, making them relatively less harmful. PM2.5 particles are much finer and more dangerous, as they can travel deep into the lungs, enter the bloodstream, and reach hormone-producing organs such as the ovaries, testes, and thyroid. Because of this ability to spread throughout the body, PM2.5 poses a greater threat to reproductive health than larger particles that mainly affect breathing.

Early Pregnancy Risks

There is also evidence suggesting that fetal growth and lung development may be affected, with risks becoming more noticeable at the population level rather than in individual cases.

Air pollution is one of several factors influencing fertility in India, particularly in urban areas. Although it is rarely the sole cause of infertility, reducing exposure to polluted air can improve reproductive outcomes. This is especially relevant for couples undergoing IVF and during the early stages of pregnancy, highlighting the need to view clean air not just as an environmental issue, but as an important aspect of reproductive health.