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.

We often hear of dementia as an adult, or older people's disease, but, a father from Glasgow shares how his four-year-old daughter was diagnosed with the condition. Childhood Dementia news of Darren Scott's daughter was delivered to him like a "complete thunderbolt", he tells Sky News. She was diagnosed with the condition before she turned four. Five doctors were waiting, when Sophia Scott, who had just turned four, were summoned to a Glasgow hospital room. Then came the worst news. Scott was told that his daughter could not live beyond the age of 16. "We were told... there was nothing they could do. It was a moment that broke us, shattered our lives. We have never recovered," he says.

What Is Childhood Dementia?

As per Dementia Australia, childhood dementia is a rare brain condition that affects one in every 2,900 babies globally. Childhood dementia is a group of serious brain conditions that interfere with a child’s memory, behavior, emotions and ability to communicate. It isn’t caused by lifestyle or ageing. Instead, it stems from more than 100 rare genetic disorders that children are born with. These include conditions such as Niemann-Pick type C, Batten disease and Sanfilippo syndrome.

No two children experience childhood dementia in the same way. The illness progresses differently for each child, but one thing remains constant: there is currently no cure. Like adult dementia, childhood dementia is progressive, meaning symptoms worsen over time. Heartbreakingly, around half of all affected children do not survive beyond the age of 10.

What causes childhood dementia?

Childhood dementia is genetic. Globally, about one in every 2,900 babies is born with a condition that can lead to childhood dementia. In Australia alone, an estimated 1,394 children were living with dementia in 2021.

The conditions that cause childhood dementia fall into several categories, including inborn errors of metabolism, lysosomal disorders, mitochondrial disorders, mucopolysaccharidoses, leukodystrophy, neurodegeneration with brain iron accumulation (NBIA), and peroxisomal diseases.

Signs and symptoms to look out for

Symptoms can begin in early childhood or appear much later, sometimes not showing up until the teenage years. The progression may be rapid or unfold slowly over several years, deeply affecting both the child and their family.

Much like adults with dementia, children may struggle with memory loss, confusion, changes in personality, anxiety or fear, and severe sleep disturbances. They may also find it difficult to concentrate, learn, communicate or understand things, and some experience behavioral challenges such as hyperactivity.

In addition, childhood dementia can affect the body beyond the brain. Children may develop problems with their bones or joints, experience issues with the heart, lungs or digestive system, lose their ability to move, see or hear, or have seizures.

As the condition advances, children gradually lose skills they once had — talking, walking, reading, writing and playing. Eventually, the body itself begins to shut down. Without major medical breakthroughs and more research, most children with childhood dementia will continue to face a shortened life, often not surviving beyond their teenage years.

India is staring at a sharp rise in lung cancer cases over the next few years, with experts warning that the disease is no longer confined to smokers alone. A recent study published in the Indian Journal of Medical Research projects a significant increase in lung cancer incidence by 2030, with certain regions, particularly the North-East, expected to bear a disproportionate burden. Alarmingly, women are showing one of the fastest rises in new cases.

At a time when the country is on the brink of what researchers describe as a “tsunami” of lung cancer cases, doctors stress that public awareness, early detection, and breaking long-held myths are more important than ever.

Lung Cancer Is No Longer Just a Smoker’s Disease

Lung cancer has long been associated almost exclusively with smoking, but experts say that narrative is outdated. Speaking to The Times of India (TOI), Dr Arun Kumar Goel, Chairman – Surgical Oncology at Andromeda Cancer Hospital, Sonipat, explained that while smoking remains the biggest risk factor, non-smokers are increasingly being diagnosed with the disease.

“Air pollution, indoor cooking smoke, passive smoking, radon gas exposure, occupational hazards like asbestos, and even family history can contribute to lung cancer,” Dr Goel explined. He added that adenocarcinoma, a subtype of lung cancer, is particularly common among non-smokers and appears to be linked more to environmental and genetic factors than tobacco use.

Early Symptoms Are Easy to Miss

One of the biggest challenges with lung cancer is that its early symptoms are often vague and easily mistaken for common respiratory problems. Dr Goel told TOI that persistent cough, changes in cough pattern, coughing up blood or mucus, unexplained chest pain, breathlessness, fatigue, and sudden weight loss are warning signs that should not be ignored.

“In India, lung cancer symptoms often overlap with illnesses like tuberculosis, which leads to delays in diagnosis,” he said. As a result, many patients only seek medical help when the disease has already progressed to an advanced stage.

What a Diagnosis Changes Overnight

A lung cancer diagnosis can be life-altering, both physically and emotionally. According to Dr Goel, patients are suddenly faced with difficult treatment decisions, ranging from surgery and chemotherapy to radiation or targeted therapy. Physical symptoms such as breathlessness and exhaustion can significantly affect daily life.

Emotionally, patients may experience shock, anxiety, fear about the future, concerns for their families, and a loss of independence. “Support from medical teams, counselling services, and loved ones plays a crucial role during this period,” he said.

The Biggest Myth That Delays Care

The most damaging myth, experts say, is the belief that lung cancer only affects smokers. Dr Goel warned that this misconception often results in non-smokers dismissing symptoms or doctors delaying screening. “Anyone can develop lung cancer, regardless of smoking history,” he said.

Early Detection Can Save Lives

If there is one message the public should remember, Dr Goel said, it is that early detection can dramatically improve outcomes. Persistent cough lasting several weeks, unexplained breathing difficulties, or ongoing chest discomfort should prompt immediate medical attention.

“Recognizing symptoms early and seeking help can change the course of treatment and significantly improve quality of life,” he said.

Face masks are not adequate when it comes to protection against flu-like illnesses, including COVID, said the World Health Organization (WHO) guidelines. As the number of flu cases rise in the US and the UK, this WHO guideline, may be of use. The guidelines noted that the surgical masks worn by doctors and nurses, when they are face to face with a patients are no longer providing the protection, and must be replaced with respirators.

The guidelines noted in a letter to the WHO chief Dr Tedros Adhanom Ghebreyesus, noted there is “no rational justification remaining for prioritizing or using” the surgical masks that are ubiquitous in hospitals and clinics globally, given their “inadequate protection against airborne pathogens”. “There is even less justification for allowing healthcare workers to wear no face covering at all,” the letter read.

When COVID was at its peak, an estimated of 129 billion disposable face masks were being used around the world every month. These were used by the healthcare workers as well as general public. These surgical masks were most widely available and recommended by most health authorities during that time. However, respirators were then designed to filter tiny particles. Then came the masks FFP2/3 standards in the UK or the N95 in the US. Evidence also supported that many countries are switching to these masks and that they are more effective. This resulted in fewer infections in patients and health professionals, as well as reducing the rate of sickness, and burnout of the healthcare professionals.

What Is The Key Difference Between Respirator and Surgical Mask?

Face masks are loose in fitting and are designed for one-way protection. It protects others from coughs and sneezes. WHO recommends a three-layer mask when people cannot socially distance. However, not all face masks have a safety rating.

The respirators on the other hand has a tight fitting, which creates a facial seal and filters both inflow and outflow of air. It tightly covers the nose and the mouth. It also removes 94% of all particles that are 0.3 microns in diameter or larger. It is also designed to protect the wear up to the safety rating of the mask.

COVID - Airborne or Not?

The WHO has faced criticism for its delayed acknowledgment of Covid-19’s airborne transmission. The letter urges the agency to reassess its earlier position and clearly communicate to the public that the virus spreads through airborne respiratory particles.

Professor Trisha Greenhalgh of the University of Oxford, a signatory to the letter whose research is widely cited in it, said that infection occurs only when germs enter the body. She explained that respirators, which seal tightly against the face, force air to pass through high-grade filters that block airborne pathogens. In contrast, she noted, medical masks fit loosely and allow significant air leakage.

Supporters of the letter include members of the World Health Network, leading US epidemiologist Eric Feigl-Ding, and Guardian columnist George Monbiot.

Responding to the letter, a WHO spokesperson said it would undergo “careful review.” The spokesperson added that the organization consults experts across diverse health and economic settings when developing guidance on personal protective equipment for healthcare workers, and that its Infection Prevention and Control guidelines for epidemic- and pandemic-prone respiratory infections are currently under review in light of the latest scientific evidence.