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.

Even a mild case of COVID-19 may trigger long-lasting eye problems, with new research revealing that persistent inflammation and nerve damage could be responsible for symptoms that standard eye tests often fail to detect.

The study, led by researchers at Linköping University in Sweden and published in Nature Communications, sheds light on why some COVID-19 survivors continue to experience debilitating vision issues months or even years after infection.

The research began after people who had recovered from mild COVID-19 sought medical help for persistent eye complaints. Many reported:

• Severe eye pain
• Light sensitivity (photophobia)
• Difficulty reading and focusing
• Extreme eye fatigue

Many participants said the condition significantly disrupted their daily lives, preventing them from working or continuing their education.

What the Study Found

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Researchers evaluated 100 people who developed eye problems after mild COVID-19 but had never been hospitalized. Their symptoms had persisted anywhere from three months to three years.

The findings were compared with those of 32 people who had recovered from mild COVID-19 without developing eye symptoms.

Using advanced imaging and laboratory techniques, researchers identified several abnormalities that conventional eye exams failed to detect.

Persistent Inflammation and Nerve Damage

The study found evidence of:

• Long-term inflammation in the eyes
• Damage to nerves controlling multiple eye functions
• Abnormal immune activity involving T cells
• Changes in proteins found in tear fluid

Lead author Petros Moustardas, senior research associate at Linköping University, said the findings indicate that COVID-19 may trigger a severe immune reaction in the eyes, resulting in chronic inflammation and nerve dysfunction.

Why Light Sensitivity Happens

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One of the most common complaints among participants was extreme sensitivity to light. Researchers found that their pupils were allowing too much light into the eyes because of impaired nerve control.

This abnormal pupil function was also associated with:

• Headaches
• Difficulty reading
• Trouble maintaining focus

An Unusual Eye Movement Disorder

The study also identified impaired coordination between the two eyes.

Some participants developed adult-onset strabismus—commonly known as crossed eyes—a condition that is rare in adults.

Researchers believe this occurred because COVID-19 affected the nerves responsible for controlling eye muscles.

A New Way to Diagnose COVID-Related Eye Problems

Because routine eye tests often miss these abnormalities, the research team developed two diagnostic models.

The first relies on specialized ophthalmic tests available at advanced eye clinics, while the second combines these examinations with tear fluid protein analysis to improve diagnostic accuracy.

Researchers hope these models will help doctors recognize COVID-related eye syndrome earlier and pave the way for future treatments.

"We found that the problems experienced by those affected were not detectable by standard tests. We had to perform specialised examinations to detect deviations. The puzzle pieces then fell into place, and we found explanations for the symptoms," said Neil Lagali, professor of experimental ophthalmology at Linköping University.

He added that while the findings provide important clues about how COVID-19 affects the eyes, more research is needed to develop effective treatments for those living with persistent vision problems.

Yawning has a certain fact attached to it, which is without a doubt a reason for curiosity and amazement among people. Many of you must have noticed that when someone nearby yawns, you often end up yawning too. Even in some cases, a person yawns just after hearing the word yawn or watching someone yawn on screen.

Yawning itself is a natural physical process that involves taking a deep breath and stretching the muscles used for breathing. Some experts suggest that it may help increase alertness and leave us feeling refreshed. However, while scientists have proposed several theories about the purpose of yawning, one question continues to intrigue researchers: why are yawns so contagious?

Dr. Debanjan Pan, Consultant Psychiatrist at Saltlake Mindset, told Health and Me, "Contagious yawning may be linked to mirror neurons, which help us understand and imitate the behavior of others. Humans have survived by living in groups, and our brains are naturally wired to synchronize with the people around us. When we see someone yawn, the same neural networks in our brains may become activated, prompting us to yawn as well."

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Yawning involves taking a very deep breath, which increases oxygen intake and stimulates several parts of the respiratory system. This deep inhalation can temporarily raise the heart rate and boost blood circulation to the spinal cord and the brain, making a person feel calmer and more relaxed afterward.

According to Dr. Pan, this sense of relaxation may also explain why yawning is contagious. When we see someone else yawn, the brain's empathy circuits, particularly those linked to mirror neurons, become active. As humans are highly social beings, we often unconsciously mimic the behaviour and emotions of people around us, causing a yawn to spread from one person to another.

But there might be a question: if yawning is contagious because humans are social animals and human brains are naturally wired to synchronize with the people around them, then why doesn't coughing and sneezing have the same effect?

Dr. Vikas Mittal, Director - Pulmonologist, CK Birla Hospital, Delhi, addressed this very issue and explained, "Yawning is different than coughing and sneezing. Coughing and sneezing are protective reflexes that protect you from irritants. They can be contagious, but that contagion comes after one or two days, not immediately as is with yawning. Yawning occurs because of the brain's automatic self-mirroring networks."

Dr. Mittal further added, "What it means is when somebody yawns, then your brain starts imitating that unintentionally. Not only yawning, but other emotions like a smile, laugh, and fear can trigger the same emotion in the people around you. This is because of the same brain's automatic self-mirroring networks."

Contagious yawning appears to be more than a simple reflex, offering insights into empathy, social bonding, and the human brain.

Cardiovascular-kidney-metabolic (CKM) syndrome is emerging as a major public health threat, according to new guidelines from the American Heart Association (AHA), which identify obesity as a key driver of the condition's development and progression.

The guidelines, jointly issued by the AHA and the American College of Cardiology (ACC), reframe excess weight as more than a number on the scale, describing it as a significant health risk closely linked to diabetes, chronic kidney disease and cardiovascular disease.

According to the AHA, nearly 9 in 10 adults in the United States have at least one condition associated with CKM syndrome. These include high blood pressure, abnormal cholesterol and other lipid disorders, high blood sugar, reduced kidney function and excess body weight.

With obesity rates continuing to rise, the guideline urges healthcare professionals to have prevention-focused conversations with patients about maintaining a healthy weight to reduce the risk of future heart, kidney and metabolic diseases.

“CKM syndrome is a real, rising public health threat,” said Chiadi E. Ndumele, an American Heart Association volunteer and chair of the writing committee for the new guideline.

“In terms of CKM health, weight is not just about a number on a scale — people with the same body weight can have very different health profiles. Rather, what’s most important is how fat tissue affects your metabolic health. This includes how your body manages blood sugar levels and how fat is used and stored,” Ndumele, who is also director of obesity and cardiometabolic research at Johns Hopkins University in Baltimore.

The New CKM Syndrome Guideline

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The updated guideline replaces the 2013 recommendations for managing overweight and obesity. CKM syndrome itself was first formally defined by the American Heart Association in 2023.

The guideline highlights several strategies to improve the prevention and treatment of CKM syndrome:

• Use the Predicting Risk of Cardiovascular Disease EVENTs (PREVENT) equations to estimate 10-year and 30-year cardiovascular disease risk. Unlike previous tools, PREVENT incorporates kidney and metabolic health factors for a more comprehensive risk assessment.
• Screen patients for social determinants of health, including food insecurity, housing instability and financial strain, which can increase the risk of CKM syndrome.
• Promote coordinated, multidisciplinary care focused on healthy lifestyle behaviors, including physical activity, nutrition, weight management, blood pressure control, blood sugar management and cholesterol reduction.
• Alongside lifestyle interventions, use medications and surgical therapies when appropriate to manage blood pressure, cholesterol, blood sugar and obesity while protecting heart and kidney health.
• For the first time, the guideline recommends GLP-1-based therapies for select individuals with obesity and/or Type 2 diabetes who are at elevated cardiovascular risk. Metabolic and bariatric surgery is also recognised as an effective treatment option for eligible patients.

How Can CKM Syndrome Be Prevented?

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The guideline emphasizes that early lifestyle changes can significantly reduce the risk of heart attack, heart failure, stroke and kidney failure.

People are encouraged to follow the AHA's Life's Essential 8, which promotes

• regular physical activity,
• a heart-healthy diet,
• maintaining a healthy weight,
• controlling blood pressure,
• maintaining blood sugar
• better cholesterol control,
• avoiding tobacco,
• getting sufficient quality sleep.