World Aids Day
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.
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.
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.
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.
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.
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.
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.
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The discrepancy between Pennsylvania’s reported measles-associated deaths and the US Centers for Disease Control and Prevention’s national tally sparked a political and public-health controversy.
In an exclusive interview with HealthandMe, Dr Paul Offit, paediatrician and director of the Vaccine Education Center at Children’s Hospital of Philadelphia and former member of the CDC’s Advisory Committee on Immunization Practices, accused US Health Secretary Robert F. Kennedy Jr. of adopting a “see-no-evil approach” to the outbreak.
He criticised the Trump administration’s handling of measles deaths, the proposal to split the measles, mumps and rubella (MMR) vaccine, and a new federal initiative to expand vaccine-injury reporting.
Pennsylvania reported six measles-associated deaths, according to its Department of Health. The CDC, meanwhile, had confirmed two deaths.
The figures have become the focus of a dispute over how deaths among measles patients should be classified and included in government data.
During the interview, Offit spoke about the discrepancy between Pennsylvania’s report of six deaths and CDC’s count of two. “These are measles-related deaths,” he said, arguing that measles had contributed to the deaths reported by the state.
“Had these children or adults not had measles, in the case of the one-day-old and few-month-old, they would have never died,” Offit said.
He accused Kennedy of refusing to acknowledge the state’s report and said the federal government’s approach risked obscuring the seriousness of the outbreak.
“This is just Robert F. Kennedy Jr. refusing to acknowledge the fact that he is an excellent anti-vaccine activist,” Offit said.
The disagreement involves more than a difference in numbers. Pennsylvania health officials count deaths that meet the state’s epidemiological definition of measles-associated fatalities.
The federal government has moved towards requiring confirmation through the National Center for Health Statistics. It now considers the fact that measles is listed as the underlying cause of death before including a fatality in its tally. This process can take longer than state reporting.
A death occurring in someone with measles does not automatically establish that the infection caused the death. However, measles can lead to serious complications, including pneumonia and brain inflammation, which can be fatal.
Also read: Sixth Measles-Associated Death Reported In Pennsylvania As Cases Cross 1,100
Offit said the reported number of measles cases in Pennsylvania could substantially underestimate the actual scale of transmission. “You can assume that's off by a factor of at least five. I think there's between 5,000 and 10,000 cases of measles in our state,” he said during the interview.
Pennsylvania’s Department of Health reported 1,260 confirmed cases across 42 counties as of October 16, alongside 225 hospitalisations. “So this is the tip of a much, much bigger iceberg,” Offit said.
He also highlighted the risk among adults who may neither have acquired immunity through previous infection nor received vaccination.
“The thing that strikes me about measles right now is it's an adult disease,” he said, pointing to people in their 20s, 30s and 40s who may remain susceptible.
Offit argued that the resurgence should be attributed to failure to vaccinate rather than a failure of the vaccine itself. “Certainly not a vaccine failure. The vaccine doesn't work if you don't get it,” he said.
While addressing the measles crisis in the United States, Offit also addressed President Donald Trump’s proposal to separate the combined MMR vaccine into three individual shots.
The MMR vaccine has been used for decades. Trump’s executive order to split the vaccine had revived a debate that the combined vaccine causes autism, which has been discredited.
He referred to research conducted over several decades that has not established a causal link between MMR vaccination and autism. “There was the MMR vaccine in 1971. So we've had 50 plus years of the MMR vaccine,” he said.
Offit argued that separating the vaccines would increase the number of injections children receive without providing an established benefit.
“There's no reason to do it. Just makes it more expensive, less available, and has a longer period of time when children aren't getting vaccines,” he said. “And they get six shots instead of two for no benefit.”
He also said the proposal had made parents more skeptical about vaccination.
The debate sparked concerns as delaying vaccination can leave children susceptible to measles during the period before they receive protection. Any changes to vaccine schedules or formulations need to be assessed against evidence of safety, effectiveness and practical consequences for vaccine access.
Offit also criticised Kennedy’s initiative to expand research into vaccine injuries and improve reporting through the Vaccine Adverse Event Reporting System (VAERS).
Announced by the US Department of Health and Human Services in October, the initiative includes a new National Institutes of Health clinic, plans to record vaccine-related adverse events in electronic health records, modernisation of VAERS and a proposal to reimburse doctors for reporting suspected vaccine injuries.
When asked if the initiative was a useful step towards vaccine safety monitoring, Offit replied: “Not in his hands.”
He alleged that the information collected under the programme could be misrepresented to support claims linking vaccines to chronic diseases, including autism, diabetes and multiple sclerosis.
Offit also questioned whether the existing reporting system was being misunderstood. He said that "we did a pretty good job" establishing the existing vaccine injury reporting system.
He further described VAERS as a “noisy warning system”, explaining that reports can help identify adverse events but cannot establish that a vaccine caused a reported health problem.
The CDC says VAERS accepts reports of health problems after vaccination even when the person reporting them is unsure whether the vaccine caused the event.
Offit cited the example of the RotaShield rotavirus vaccine to illustrate how safety signals should be investigated. Reports of a possible serious adverse event prompted further study, which helped establish a link and led to the vaccine’s withdrawal.
His did not say that vaccine safety should go unexamined, but that reports must be investigated using reliable scientific methods.
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When Andrea de Armas was diagnosed with breast cancer at 26, she was preparing for a future that looked very different from the one she was suddenly handed.
Along with surgery and chemotherapy, she had to make decisions about her fertility and adjust to the of long-term consequences from treatment.
Now 30 and cancer-free, the US woman is still taking hormone therapy. The treatment has put her into temporary menopause.
“I’m really lucky. I feel like I’m doing OK,” de Armas told CBS News. “It took me a little bit to kind of adjust. It wasn’t immediate; it took time. It took understanding the kind of changes my body was going through. But I’m able to live a pretty normal life for a 30-year-old.”
Andrea’s experience highlights a revealing challenge of breast cancer in younger women. Young women who survive breast cancer face a series of emotionally heavy decisions about menstrual cycles, fertility, sexual health and emotional well-being, and menopause that comes decades earlier than expected.
De Armas initially struggled to get her concerns taken seriously. She was eventually diagnosed with breast cancer in 2023 and discovered that she carried a genetic mutation associated with an increased risk of the disease.
She underwent a lumpectomy in June, followed by chemotherapy. She later had a bilateral mastectomy and reconstruction, scheduling treatment around her studies so she could continue her physician assistant programme.
“We worked together as a team,” said Dr. Cristina Lopez-Penalver, the surgical oncologist at Baptist Health's Herbert Wertheim Cancer Institute who treated her. “She was really not about ready to let this breast cancer get in her way.”
De Armas graduated as a physician assistant in 2025 and began working a month later. However, despite completing surgery and chemotherapy, she continues to take hormone therapy because of the characteristics of her cancer.
That medication has placed her in temporary menopause, a treatment-related effect that can be particularly difficult for younger women to navigate.
Also read: Breast Cancer: Know the Risks, Recognise the Signs & Get Checked
Menopause occurs when the ovaries stop releasing eggs and producing lower levels of hormones, particularly oestrogen.
Although natural menopause usually occurs in the late 40s or early 50s, some cancer treatments can bring on menopause much earlier.
According to the American College of Obstetricians and Gynecologists (ACOG), chemotherapy can damage the ovaries, causing periods to become irregular or stop altogether.
Hormone therapy can also block oestrogen's effects to help prevent hormone-sensitive breast cancer from returning.
Some women experience temporary ovarian suppression, in which medication switches off ovarian function during treatment.
Others may develop permanent ovarian damage and early menopause. The outcome depends on the treatment, the woman's age and her ovarian function before treatment. In de Armas' case, hormone therapy has brought on temporary menopause.
The transition can be more abrupt than natural menopause, leaving women with symptoms that affect daily life. Common effects include:
The National Cancer Institute notes that treatment-related ovarian insufficiency can also cause joint pain, reduced libido and difficulty concentrating.
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Menopause is often characterised symptoms like by hot flashes and night sweats. But for some women, the transition can also bring changes in mood, memory and concentration that may be harder to identify. These symptoms can affect everyday life and may be misconstrued as stress, ageing or the emotional effects of children leaving home.
On World Menopause Day 2026, Dr. Abha Majumdar, gynaecologist and one of the lead IVF specialists in the country, told HealthandMe that women and their families need to identify the least obvious symptoms of perimenopause, the transition leading up to menopause.
Empty nest syndrome refers to the feelings of grief, loneliness or loss of purpose that some parents experience when their children leave home to study, work or start their own families. The transition can bring changes to family routines and relationships, especially for parents who have spent years raising their children.
Dr Abha points out that mood changes in women during their 40s should not automatically be attributed to empty nest syndrome.
Perimenopause, the transition leading up to menopause, can also involve mood swings, forgetfulness and difficulty managing everyday tasks.
As she puts it, “Suddenly, around 45 or around that time, she starts feeling depressed. Everyone says, "Oh, children have grown up, you know, it is like an empty nest. But it is not just an empty nest.”
Recognising the symptom is key so that women experiencing new or persistent symptoms are not dismissed as simply struggling with their children leaving home, and can seek medical advice when needed.
Perimenopause can bring changes that don't relate to menstrual or hormonal cycle. Women may find themselves to be forgetful about routine things, struggle to concentrate or feel overwhelmed by tasks they previously managed with ease.
Dr Abha explains how these changes may appear in everyday life. She said, “She starts forgetting. She starts finding it difficult to cope with the daily chores which she did very easily before that.”
She says women may also face cognitive symptoms like brain fog and mood swings during this phase. She said, “Forgetfulness, cognition difficulties, brain fogging, mood swings.”
These symptoms can be confusing when women do not know that they come with menopausal transition. Changes in mood, for instance, may be misconstrued as reaction to family responsibilities, work stress or other pressures, while difficulties with memory and concentration may completely go unnoticed.
Also read: Menopause Abruptly Shifts Bones, Liver And Blood Fats, Study Finds
Perimenopause does not begin at the same age for everyone. Also, the transition may continue for several years before menopause sets in.
Dr Abha said that perimenopause may last for five or even 10 years before menopause sets in. She also said that fluctuating oestrogen levels are part of this phase.
“She's probably going through a perimenopause, which is it estrogen deprived and then comes up, goes down and comes up, and goes down and comes up. It may take couple of years for menopause to set in," she said.
Since the transition can be prolonged, understanding its symptoms is important for women as well as their families. Dr Abha explains that husbands and adult children should be attentive to changes in a woman's behaviour, mood or ability to manage familiar routines, rather than dismissing them.
She also stresses that women's health after menopause deserves attention, particularly as life expectancy increases.
She said, “Please support her at that time because she's got 25 years more to live right away. Maybe more.”
Mood changes, fatigue, sweating and memory difficulties should not automatically be attributed to menopause. Other health issues can produce similar symptoms, which makes medical attention important.
Dr Abha advises women to seek help whenever they notice a change that makes everyday activities more difficult.
She said, “Any point. If she feels something is happening to her, she's not being able to cope with her daily chores. She used to cook so effortlessly, now it takes a lot of effort. She starts getting tired, she sweats. That is the time. May it be 40, may it be 45, may it be 38 also.”
A doctor can assess menstrual cycle and determine whether symptoms are related to perimenopause or another condition. Dr Abha says investigations may also help identify other possible explanations, including vitamin deficiencies or thyroid problems.
“So, they can be sorted out. So don't avoid going to a doctor if you feel something is changing in your body. And what you were coping with earlier, you're not being able to cope with that.”
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