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.

Clear vision does not always mean that the eyes are healthy. Diabetes can damage the retina the sensitive layer at the back of the eye long before a person notices any change in eyesight.

This happens because high blood sugar can weaken the blood vessels that supply the retina causing them to leak fluid or blood.

What happens as retinopathy progresses?

Diabetic retinopathy is a complication in which high blood sugar damages the blood vessels. In the stages these vessels may swell or develop small areas of bleeding without affecting vision.

As the condition advances, reduced blood supply can cause abnormal new blood vessels to grow. These vessels are fragile. May bleed into the vitreous the clear gel inside the eye. In some cases, scar tissue can pull the retina away from its normal position leading to retinal detachment and potentially permanent vision loss.

Also read: Eye Drop Recall: Nearly 750,000 Products Pulled Over Sterility Concerns in US

How diabetes affects central vision

Diabetes can also affect the macula, the part of the retina responsible for sharp detailed vision. When fluid builds up in this area it can cause macular oedema and gradually affect the quality of vision.

It may lead to:

• Distorted central vision
• Difficulty reading or recognising faces
• Problems with activities that require clear detailed vision, such as driving

Diabetic macular oedema can occur at different stages of diabetic retinopathy and does not always cause symptoms in the early stages.

Also read: Eye Twitching: Is It Just Stress Or Something Serious?

Who is at risk?

The likelihood of eye damage increases with the duration of diabetes and poor blood sugar control. High blood pressure, abnormal cholesterol levels and kidney disease can further increase the risk.

Women with diabetes may also need monitoring during pregnancy as hormonal and blood sugar changes can worsen existing retinal disease.

Why regular eye examinations matter

On World Sight Day, doctors recommend that a routine eyesight test may not detect damage to the retina. People with diabetes should therefore undergo an eye examination, including a dilated retinal examination at intervals recommended by their ophthalmologist.

Keeping blood sugar, blood pressure and cholesterol, under control can help reduce the risk of complications. If damage is detected treatment may include eye injections, laser therapy or surgery depending on its severity.

Diabetic eye disease can often be managed effectively when identified early. Regular retinal examinations remain important when a person can see clearly as changes may develop before symptoms appear.

By Dr Ashu Agarwal, Senior Consultant, Opthalmology, Indraprastha Apollo Hospital, Delhi

Menopause is a natural stage of aging that ends menstruation and reproductive function. It usually occurs between ages 45 and 55.

But growing interest in extending the reproductive years has raised a question: Can menopause be delayed, and would doing so actually benefit women's health?

Longevity influencer Kayla Barnes-Lentz, in her mid-30s, recently told Business Insider that she is trying to delay menopause until 60 using lifestyle changes and experimental treatments.

Can Menopause Be Delayed?

Scientists are studying ways to slow ovarian aging, including ovarian tissue freezing and drugs such as rapamycin.

Early human research suggests rapamycin may slow ovarian aging by around 20%. However, evidence remains limited, and the drug is not FDA-approved for delaying menopause. Its use for this purpose is off-label.

The 2024 Research by Dr. Kutluk Oktay at Yale School of Medicine has also explored whether menopause could eventually be postponed or prevented by preserving ovarian function.

But delaying menopause is not necessarily an all-round health benefit. Longer estrogen exposure may support bone, heart and brain health, while potentially increasing the risk of some hormone-sensitive cancers.

What Are The Risks Of Early Menopause?

Also read: ‘I Was Vocal About Cancer But Silent About Menopause Out Of Shame’, Says Actress Lisa Ray

Menopause around age 45 or younger can affect several aspects of health as estrogen levels fall.

• Bones: Faster bone loss and higher osteoporosis risk.
• Heart: Changes in blood vessels and cholesterol may increase cardiovascular risk.
• Brain: Hormonal changes can affect memory and cognition.
• Sexual health: Vaginal dryness and reduced lubrication can cause discomfort.
• Urinary health: Lower estrogen can contribute to urinary symptoms and incontinence.

Is Later Menopause Healthier?

Menopause at 55 or older means longer exposure to estrogen and has been associated with some benefits, including better bone and cardiovascular health.

But the picture is not straightforward. Longer estrogen exposure has also been linked to a higher risk of breast, endometrial and ovarian cancers. So, later menopause should not automatically be considered healthier.

Can HRT Delay Menopause?

No. Hormone replacement therapy treats menopause symptoms but does not stop or postpone menopause.

It can help with hot flashes, sleep problems and vaginal dryness and may benefit some women at risk of bone loss. HRT can contain estrogen alone or estrogen with progesterone.

Its risks and benefits depend on factors such as age, timing, formulation, dose and duration. For appropriate women, the benefit-risk balance is generally more favorable when treatment begins before age 60 or within 10 years of menopause.

Can lifestyle delay menopause?

Genetics play a major role in determining when menopause occurs, and there is no lifestyle change proven to reliably postpone it.

Some factors have been linked with later menopause or a lower risk of early menopause:

• Breastfeeding: Longer breastfeeding has been associated with a lower risk of early menopause.
• Exercise: Supports overall health, although evidence that it directly delays menopause is limited.
• Not smoking: Smoking is linked to earlier menopause.
• Healthy diet: Some research links diets rich in antioxidants and omega-3 fatty acids with later menopause.

These habits cannot guarantee a later menopause but can support overall health through midlife.

For now, treatments specifically designed to delay natural menopause remain experimental. There is no established method that can reliably and safely postpone menopause in healthy women.

The suspected plague situation in Russia has reportedly claimed another life, fueling fears of a potential outbreak. However, Russia has not confirmed that either death was caused by plague, and investigations into the cases are ongoing.

India, which has witnessed plague outbreaks in the past, including the 1994 Surat outbreak and a pneumonic plague outbreak in Himachal Pradesh in 2002, also has rodent populations that can serve as reservoirs for plague. But does the situation in Russia pose a risk to India if plague is eventually confirmed?

To understand the potential risk to India, HealthandMe spoke to two experts with experience investigating plague outbreaks in India.

Plague From Test-Tube Exposure?

Also read: Russia Plague Scare: Is Pneumonic Plague Deadlier Than Bubonic & Septicemic Plague?

The death of a 28-year-old laboratory worker in Russia’s Irkutsk region has raised concerns about possible plague exposure. Reports said she may have accidentally broken a test tube containing Yersinia pestis, the bacterium causing plague, while collecting samples. However, Russian authorities have not confirmed plague and said she died of pneumonia of unknown cause.

Dr NK Ganguly, former Director General of the Indian Council of Medical Research (ICMR) told HealthandMe that the case has not been established as plague and questioned whether a test-tube exposure could explain plague pneumonia.

“Actually, the case in Russia has not been proven to be plague. It has been reported as a case of unknown cause and undiagnosed pneumonia. They have been investigating plague among about 2,000 people in the vicinity, as well as among people in the laboratory. So, they have not confirmed it as a plague case. And from a test tube exposure, it is difficult to have plague pneumonia.”

Unconfirmed reports have also claimed another death linked to the same laboratory, but this has not been independently verified.

Dr Ganguly was one of the people who investigated the 1994 plague outbreak in Maharashtra’s Beed district.

Should India Be Concerned?

There is currently no indication that the situation in Russia poses a significant pandemic risk to India.

Dr Ganguly said there is no reason for India to be very concerned about the Russian situation, particularly because plague has not been confirmed.

“So from the Russian plague, there is no, we need not be very worried. Firstly, they have not reported it as plague. It might be plague, but they have not reported it as plague.”

The WHO has also assessed the risk to the wider population as low. WHO spokesperson Christian Lindmeier said the initial assessment based on available information put the risk at moderate to low for Irkutsk, low for Russia as a whole and very low for the WHO European Region.

How Does Plague Spread?

Plague is caused by the bacterium Yersinia pestis and is primarily associated with rodents and their fleas. It can occur in different forms, including bubonic, septicemic and pneumonic plague. Russia is suspected to have pneumonic plague.

Dr Amitabh Banerjee, who investigated the Himachal Pradesh plague outbreak in 2002, said plague does not typically spread rapidly from person to person.

“So it's not a very quick transmission, particularly person to person. But plague is a disease which cannot be eradicated because it is in wildlife, it is in rodents and all. So the only thing is hygiene and, with modern antibiotics, there should not be any panic,” he told HealthandMe.

Banerjee also noted that pneumonic plague can be severe, while bubonic plague does not typically spread easily from person to person.

“So pneumonic plague can be very deadly particularly pneumonic plague and that will be localized pandemic it is not possible because those persons will be very sick, they cannot move out or not and bubonic plague will not transmit very easily from person to person and both are treatable…”

How Should India Prepare?

While Dr Ganguly said there is no immediate reason for India to be worried about the Russian situation, he stressed the importance of continued surveillance of rodents and other animals, particularly where wildlife and human habitation overlap.

“So the main thing is that go on doing surveillance in the rats and other, in the vicinity of where the forest and the human habitat march. And whenever you find any activity, then take preventive precaution.”