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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A 43-year-old mother from Northern Ireland got diagnosed with an exceptionally rare cancer after months of pain, continual bleeding and abdominal swelling. She said that these symptoms were initially and inaccurately attributed to perimenopause, anxiety and constipation.
Nicola Crymble’s symptoms started in 2024 after she had a copper intrauterine device (IUD) inserted. The bleeding and pain became so severe that she had the device removed while she was in Kenya doing mission work. “I was constantly bleeding, there was so much pain,” Crymble said.
However, her symptoms persisted even after she returned home. She said doctors initially suggested that perimenopause and anxiety could explain what she was experiencing.
By December 2024, Crymble had noticed a lump in her abdomen. It continued to grow, making everyday activities challenging. She said people even thought she was pregnant because of the swelling. She eventually went to hospital and underwent scans, which revealed a mass near her cervix. Doctors initially thought it might be a cyst.
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Crymble underwent major surgery in February 2025 to remove the tumour. She also chose to have her ovaries and fallopian tubes removed during the procedure. A month later, she received the diagnosis that she had female adnexal tumour of probable Wolffian origin, commonly known as FATWO.
The tumour is believed to develop from remnants of the Wolffian duct, an embryonic structure involved in the development of the reproductive and urinary systems. Although these structures usually regress during female development, residual tissue can sometimes pave the way for tumour growth.
FATWO is an exceptionally rare form of cancer. There are only around 150 documented cases recorded worldwide. While many FATWO tumours do not metastatize, some can behave aggressively. In Crymble’s case, the cancer later spread to her liver and vaginal vault, the upper part of the vaginal canal.
She experienced intense pain beneath her ribs before a scan revealed that the cancer had spread. Further surgery was ruled out because the tumour growths were too close to other organs.
With surgery no longer an option, Crymble and her doctors decided to proceed with chemotherapy. She began treatment on October 13, 2026, and is expected to undergo six rounds, one every three weeks.
The family is also looking for specialist advice because there is limited information available about the rare disease and the best way to treat it. Her husband, Andrew Crymble, said doctors had little experience with the condition.
“They've never seen it before, they don't know how to treat it,” he said, explaining why the family decided to share her story publicly. They hope it will reach researchers or doctors who may have more information about FATWO.
Crymble has stopped working and has found it difficult to maintain her usual family routines while undergoing treatment. The family is also seeking financial support after discovering that their life insurance coverage will not cover the treatment.
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Perimenopause can cause changes in menstrual patterns, like irregular periods. But unexplained bleeding, stubborn abdominal pain, lump or unusual swelling should not automatically be attributed to hormonal changes without seeking medical intervention.
These symptoms can occur due to many causes, and they do not necessarily indicate cancer. But worsening or unusual symptoms demand medical assessment, especially when they do not improve or when new symptoms develop.
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The effects of heatwaves, air pollution, noise and overall climate change may extend beyond physical health. According to a new report by the Earth–Brain–Health Commission published in Nature Mental Health recently, they can have a significant impact on mood, cognitive function and overall psychological wellbeing.
The commission warns that environmental changes are altering the conditions in which people live. It also talks about consequences for brain health and mental wellbeing. It also calls for mental health to become a consideration in climate policy, urban planning and environmental decision making, rather than being treated only after symptoms develop.
The findings are relevant to low and middle-income countries, where exposure to environmental hazards can overlap with greater socioeconomic problems like poverty and limited access to healthcare.
“Heat and heatwaves, air and noise pollution, extreme weather and compound events, urbanization, and the loss of green and blue spaces are associated with depression, anxiety, cognitive decline, and impaired emotional and behavioral functioning,” the commission states.
From biological changes like neuroinflammation, disruption of hormones and the body's internal clock to psychological stress and due to isolation and displacement, the commission identifies several ways through which environmental conditions may impact mental health.
Heat exposure is one of the gravest concerns in current times. Heatwaves can disrupt sleep and contribute to physiological stress, while air pollution can lead to cognitive decline. Noise pollution and stressful urban environments may fuel anxiety and depression.
These exposures are compounded by people’s standard of living. A person living in poorly ventilated housing, for example, may face heat, air pollution, financial hardship and limited access to healthcare at the same time. These combined problems can be difficult to measure by studying each exposure separately.
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Children, older adults, people with disabilities and marginalised communities may face greater exposure to environmental hazards while having fewer resources and help to cope with them.
The commission also highlights low and middle-income countries and small island developing states. These populations may face significant environmental risks but remain underrepresented in research on climate change and mental health.
Dr Vivek Benegal, senior professor of psychiatry and former head of department at the National Institute of Mental Health and Neuro Sciences (NIMHANS), Bengaluru, is among the commission's members. He said NIMHANS has been examining how climate change affects the human brain.
Benegal also pointed to a 2023 study conducted by researchers from NIMHANS and King's College London. The study found that even low levels of arsenic exposure, below World Health Organization thresholds, were associated with changes in brain structure and impaired cognitive abilities among children, adolescents and young adults.
The report recommends that governments should incorporate brain and mental health measures into environmental policies. Its recommendations include monitoring environmental exposures, identifying risks early in life, and designing healthier urban environments.
“The principal obstacles to action are organisational and financial rather than evidential,” the commission observes, noting that research cohorts, Earth-observation systems and environmental governance tools already exist but are often maintained separately.
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COVID-19 vaccines were rolled out during the pandemic, so questions about their safety, how long they protect against infection and whether mRNA technology was tested for long enough continue to dominate public debate.
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, says many concerns overlook the the evidence collected before and after the vaccines were introduced.
In an interview with HealthandMe, Offit discussed how long COVID vaccine protection lasts, what scientists have learnt about rare side effects and why the technology behind mRNA vaccines was not as new as many people thought.
“I think it is probably the best studied vaccine in human history,” Offit said. He pointed to the large number of people who received them and the safety-monitoring systems used to look for adverse effects.
The circulation of SARS-CoV-2, the virus that causes COVID-19, is sometimes used to argue that the vaccines do not work. Offit said this misunderstands the type of infection the virus causes and the protection vaccination offers.
“It’s a short incubation period mucosal infection,” he said. “So, vaccination or natural infection will protect you for about four to six months from mild to moderate disease, should protect you for longer against severe disease.”
He compared the future of COVID to influenza, saying that infections will continue even as vaccines help protect against serious illness.
“Even if everybody in the world were vaccinated every year, that virus would still circulate,” he said. “This virus is now with us forever.”
Offit said the goal of COVID vaccination is not necessarily to prevent every infection. It is to reduce the risk of hospitalisation and death, particularly among people most likely to develop severe disease.
“The goal of the vaccine is to keep you out of the hospital and to keep you from dying,” he said.
He said that people over 75, those with chronic heart or lung disease, pregnant women and people with weakened immune systems are at higher risk of developing severe complications from COVID. He said these groups should receive a vaccine every year.
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When COVID vaccines were first authorised in December 2020, the clinical trials involved approximately 35,000 participants across the Pfizer-BioNTech and Moderna studies, Offit said. Some rare side effects of the vaccine became apparent only after the vaccines were administered to much larger populations.
One such side effect was myocarditis, an inflammation of the heart muscle, and, less commonly, pericarditis, which affects the lining around the heart.
“Very quickly, it was found to be a rare cause, roughly 1 in 50,000 myocarditis,” Offit said, referring to mRNA COVID vaccines. He said cases were seen primarily in males aged 16 to 29 and were generally short-lived.
Current evidence confirms that myocarditis and pericarditis are rare but recognised risks associated with mRNA COVID vaccines. The risk has been observed most often in adolescent and young adult males, particularly within seven days after a second dose.
In June 2025, the US Food and Drug Administration required updated safety warnings for the Pfizer-BioNTech and Moderna vaccines. The FDA also noted that some patients in follow-up studies continued to show signs of heart muscle injury on MRI scans, with improvement in some cases. The long-term significance of these findings remains under investigation.
Offit also cited the example of Johnson & Johnson COVID vaccine, which was associated with a rare but serious condition involving blood clots and low platelet counts. The vaccine was no longer available in the US by May 2023.
“You're always looking and trying to find any rare side effect that's associated with the vaccine,” he said.
He added that concerns about stillbirths and pregnancy outcomes had circulated despite research examining vaccination during pregnancy.
Offit said there was “no evidence of congenital malformations, no evidence of premature birth or spontaneous abortion” in the studies he was referring to.
Another common concern is that mRNA COVID vaccines were developed too quickly and that the technology had not been studied for long enough. Offit disagreed, saying that the technology was not entirely new.
“I think it was studied for a long time,” he said. He pointed to research into mRNA as a vaccine platform that began decades before the COVID-19 pandemic.
“Drew Weissman and Katie Carrico met in 1997 and started working on mRNA as a vaccine platform, for which they won the 2023 Nobel Prize in Medicine,” Offit said.
He also referred to efforts to develop mRNA vaccines against SARS, the coronavirus that caused an outbreak in 2002 and 2003.
“But we really had, really since 1997, information about this vaccine, so like more than 20 years of studies of that vaccine,” he said. “People think it was a new vaccine, but it really wasn't that new.”
The technology had been studied before COVID-19, although the pandemic vaccines themselves still required clinical trials to establish their safety and effectiveness. After their introduction, researchers continued monitoring them to identify rare adverse events.
Offit said the decision to vaccinate should take into account both the risk of side effects and the risk posed by COVID itself. “I'm an older person, so I'm going to get a COVID vaccine every year because I think that the benefits clearly outweigh the risks,” he said.
He argued that COVID continues to cause hospitalisations and deaths, making protection against severe disease an important consideration.
He said that the benefits outweigh the risks, particularly for people at higher risk of serious illness. Individual decisions should also take account of age, underlying health conditions, previous vaccination and current medical guidance.
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