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.

In a shocking viral trend, women in Kenya are reportedly inserting cetirizine, an allergy medication, into their vaginas in an attempt to achieve vaginal tightening and enhance sexual pleasure.

The practice has prompted warnings from pharmacists and health authorities, who caution that the drug is not meant for vaginal use and could pose health risks.

The Pharmaceutical Society of Kenya (PSK) has warned against the practice, stating that the medicine is not intended for vaginal use.

"Cetirizine is an allergy medicine, taken by mouth. It is not approved or tested for any other purpose, and definitely not for vaginal use," the PSK said in a statement issued on Thursday.

It advised women who had tried the practice to stop and seek medical attention if they experienced pain, bleeding, burning, itching, unusual discharge or fever.

What Is The Cetirizine Vaginal Tightening Trend?

Also read: Is Your Allergy Medicine Safe? FDA Recalls Antihistamine Tablets Over Life-Threatening Contamination Concerns

Posts circulating on Kenyan social media, particularly TikTok, claim that cetirizine can reduce vaginal moisture and create a sensation of tightness during sex, BBC reported.

The claims have sparked online debate, with some users endorsing the practice and others questioning its safety.

The trend has also reportedly increased demand for the drug, with local media reporting price rises and shortages at some pharmacies in Nairobi.

What Is Cetirizine And Why Is Its Misuse Dangerous?

Cetirizine is an oral antihistamine used to relieve allergy symptoms such as sneezing, runny nose, itchy eyes and hives.

Kenya's Pharmacy and Poisons Board (PPB) clarified in a public safety alert issued on November 4 that cetirizine is used to treat allergic rhinitis and urticaria. It is intended for oral use and should be taken only as directed by a healthcare professional.

The Board stressed that "the drug is not approved for vaginal use or tightening and that no established scientific evidence supports such claims".

On the other hand, inserting the tablets may cause vaginal irritation, burning, soreness, pain and discomfort. It may also disrupt the vagina's natural protective environment and increase infection risk.

The PSK cautioned against confusing dryness with tightening.

"Dryness is not tightness... instead, it may increase friction, discomfort, and the risk of tissue injury," it said.

Taking more than the recommended cetirizine dose can also cause excessive sleepiness, dizziness, restlessness, confusion, shaking, a rapid heartbeat and difficulty passing urine, the PPB warned.

Kenya's Health Ministry Raises Concern

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Kenya's health ministry had also flagged the trend a day earlier. Ouma Oluga, a senior health official, expressed concern that social media users were dismissing medical warnings without considering the consequences, the BBC reported.

He suggested that authorities could introduce a system to monitor medicine distribution and purchases to identify potential misuse. No formal decision has been announced.

Pharmacists Warn Of Shortages And Misuse

The PSK said it had received reports of increased cetirizine demand, rising prices and shortages at some pharmacies.

It urged retailers not to exploit the trend, warning that people who need the drug for allergies could struggle to access it. Pharmacists were also advised against knowingly dispensing medicines for misuse.

The PPB urged women not to insert cetirizine or other oral medicines into the vagina and to consult healthcare professionals about vaginal dryness or sexual health concerns rather than follow unverified online advice.

Delhi's air quality remained in the Very Poor category on Thursday, with an AQI of 369 as pollution levels continued to rise across the Capital. With Diwali celebrations with firecracker fuel smoke to an already polluted city, concerns about respiratory health are mounting. The timing is alarming as it also coincides with the flu season, when respiratory infections are also circulating.

While air pollution and influenza both affect the respiratory system, it can put additional stress on the lungs. Pollutants can irritate the airways, trigger inflammation and weaken the lungs' natural defence mechanisms, while the influenza virus infects the respiratory tract.

Together, they can aggravate respiratory symptoms and make breathing more difficult, especially in people with pre-existing lung conditions.

According to Dr. Arup Halder, Consultant Pulmonologist at CK Birla Hospitals, CMRI Kolkata, prolonged exposure to air pollution can weaken the respiratory system's immunity.

“Exposure to air pollution, especially for long durations, can weaken the respiratory system's immunity. Fine particulates can become lodged in airways and damage the mechanisms the body has to protect itself. This makes respiratory infections much more likely, especially if viral in nature,” he told HealthandMe.

Dr. Suresh Sagadevan, Senior Interventional Pulmonologist at Gleneagles Hospital, Chennai, told HealthandMe that pollution can also interfere with the lungs' natural cleaning mechanisms.

He said that the respiratory tract contains tiny hair-like structures called cilia, which help remove dust and germs. Polluted air can affect their functioning, making it easier for respiratory viruses to infect the airways. However, pollution does not directly cause influenza nut it can compromise the respiratory system's ability to defend itself against such infections.

What Happens When Particulate Matter And Flu Affect The Lungs Together?

Also read: Delhi Air Pollution: Feeling Anxious As AQI Rises? Experts Explain The Mental Health Toll Of Breathing Toxic Air

Particulate matter and influenza together can intensify inflammation in the respiratory system.

Fine particulate matter, like PM2.5, can penetrate deep into the lungs. It can cause inflammation and oxidative stress. At the same time, influenza viruses infect the cells lining the respiratory tract.

"When both exposures occur together, the existing inflammation can become more intense, potentially worsening coughing, breathing difficulty and airway irritation. In simple terms, the lungs are dealing with two different stresses at the same time," said Dr. Sagadevan.

Dr. Halder added that PM2.5 can also interfere with the body's ability to ward off irritants from the respiratory tract, while influenza can make breathing challenging.

Facing both together can be challenging for people whose respiratory or immune systems are already compromised.

Can Diwali Pollution Make Flu Symptoms Worse?

Also read: Air Pollution In Delhi: Experts Warn Of Red Eyes, Itching, Watering In Children

Firecracker smoke can aggravate an already infected and overwhelmed respiratory system. People with flu may experience excessive coughing, wheezing, chest tightness and breathlessness when they get exposed to high levels of pollution.

"Increased Diwali-related pollution will definitely worsen respiratory symptoms for individuals with the flu, especially during this period. The gases and particulate matter from firecracker smoke can lead to chest congestion and difficulty in breathing. In some cases, the pollution can worsen existing asthma and other lung-related conditions and trigger respiratory issues," said Dr. Halder.

Dr. Sagadevan said that people with asthma, chronic obstructive pulmonary disease (COPD) and other pre-existing respiratory conditions need to be particularly careful by limiting exposure.

Who Is Most Vulnerable When Flu Season Coincides With High Pollution?

Certain groups of people may face a greater risk when respiratory infections coincide with elevated pollution levels. These include:

• Children: Their lungs are still developing, making them more vulnerable to air pollution.

• Older adults: Age-related changes can reduce respiratory capacity and make it harder to cope with added stress on the lungs.

• Pregnant women: They need to take extra precautions against respiratory infections and environmental pollutants.

• People with asthma or COPD: Pollution can trigger flare-ups, worsen airway inflammation and aggravate breathing difficulties.

• Immunocompromised individuals: A weak immune system can make it harder to fight infections and increase the risk of severe illness.

Dr. Halder explains that older adults and people with weak immunity may be more susceptible to more serious flu symptoms. Meanwhile, those with existing lung conditions may experience worsening respiratory symptoms even with short periods of pollution exposure.

Pollution Effects Vs Flu: Symptoms

Also read: Supreme Court Allows Green Crackers In Delhi-NCR Ahead Of Diwali: Are They Really Safe For Your Health?

Pollution-related respiratory irritation and influenza can lead to similar symptoms, making it difficult to distinguish between the two. However, their onset and symptoms can differ.

Pollution-related irritation develops shortly after exposure to polluted air. Common symptoms include:

• Throat irritation or discomfort
• Burning or watering eyes
• Dry cough
• Sneezing
• Wheezing
• Chest discomfort

Flu, on the other hand, is a viral infection that mostly causes a sudden onset of symptoms, including:

• Fever
• Body aches and muscle pain
• Headache
• Fatigue
• Cough
• General weakness

"However, both can occur together, and symptoms may overlap. Persistent fever, worsening breathlessness or significant weakness should prompt medical evaluation," says Dr. Sagadevan.

Dr. Halder also recommends consulting a medical professional when symptoms make it difficult to determine whether the problem is pollution-related irritation or an infection.

How To Protect Your Lungs During Diwali And Flu Season

Reducing exposure to polluted air and taking precautions against respiratory infections can help protect lung health during the festive season.

Both doctors recommend the following measures:

1. Limit outdoor exposure: Avoid spending long periods outdoors, especially after firecracker bursting and during periods of heavy smoke.

2. Wear a well-fitting N95 mask: If you need to step outside when pollution levels are high, use a properly fitted N95 mask to reduce exposure to fine particulate matter.

3. Keep windows closed: Close doors and windows during periods of heavy smoke to limit the entry of outdoor pollutants. Ventilate indoor spaces when outdoor air quality improves.

4. Avoid outdoor exercise: Vigorous physical activity increases the amount of air you breathe in, increasing exposure. Avoid exercising outdoors when air quality is poor.

5. Avoid firecrackers and second-hand smoke: Staying away from firecracker smoke can reduce exposure to harmful pollutants.

6. Get vaccinated against influenza: Stay up to date with flu vaccinations to reduce the risk of influenza and its complications.

7. Maintain hand hygiene: Wash your hands regularly for infection prevention.

8. Seek medical attention: Do not ignore worsening fever, cough, wheezing or breathing difficulties, especially if you have an existing respiratory condition.

Dr. Sagadevan concludes, "Air pollution and influenza can independently affect respiratory health, but their coexistence can place additional stress on the lungs. During the festive season, protecting our lungs through pollution avoidance, vaccination and timely medical care should be a priority."

Metformin is the first-line treatment for type 2 diabetes in adults and children aged 10 years and above. The drug has also found applications in managing Polyendocrine Metabolic Ovarian Syndrome (PMOS), formerly known as Polycystic Ovary Syndrome (PCOS). But a recent study says that it may have some potential use in a non-metabolic health condition: Long COVID.

Researchers found that people who were prescribed metformin shortly after testing positive for COVID-19 had a significantly lower risk of developing Long COVID than those prescribed other medications.

How Was The Study Conducted?

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The study, titled Metformin at the Time of COVID-19 Infection and Risk of Long COVID: A Target Trial Emulation Study, was published in the Journal of Medical Virology recently.

Researchers have been exploring metformin's antiviral and anti-inflammatory effects, especially during the early stages of COVID-19 infection. They are specifically investigating if metformin could reduce the risk of Long COVID if taken soon after contracting the infection.

The researchers examined health records of more than 21 million people from the US National COVID Cohort Collaborative (N3C). They identified adults who had tested positive for COVID-19 between March 2020 and September 2023. They compared two groups:

Metformin group: People who received a new prescription for metformin within six days of their documented COVID-19 infection.

Comparison group: People who received prescriptions for other medications, including fluvoxamine, fluticasone, ivermectin or montelukast, during the same period.

The researchers excluded people who were already taking metformin or had conditions like diabetes, PCOS or gestational diabetes that could explain why they were prescribed the drug.

After statistical adjustments to make the groups more comparable, the researchers compared 248 people in each group. They then tracked the development of Long COVID or death over the following 180 days (six months).

Also read: Can Low-Dose Naltrexone Ease Long COVID Symptoms? New Study Examines The Evidence

Can Metformin Help Reduce The Risk Of Long COVID?

People who were prescribed metformin within six days of a COVID-19 infection had a 53% lower relative risk of Long COVID or death compared to those on other medications.

“Metformin prescription within the week following documented SARS-CoV-2 infection was associated with a 53% reduction in LC/D [long COVID or death] over 6 months in this primarily Omicron-infected sample,” wrote the authors, led by researchers from the University of Minnesota Medical School.

The study found that the risk of Long COVID or death within six months was 4.0% in the metformin group as 10 out of 248 people developed symptoms.

In the comparison group, the number was 8.5% as 21 out of 248 people presented symptoms of Long COVID. Overall, the weighted chance of Long COVID or death in patients on metformin or control treatment within six days of diagnosis was 6.3%. The absolute difference between the two groups was 4.5 percentage points.

“These results are also consistent with a recent sequential target trial analysis in the United Kingdom that assessed metformin started within 90 days of infection, HR [hazard ratio] 0.36,” the authors wrote. “The replication of results in clinical trials is important for informing treatment guidelines.”

More About Long COVID

Long COVID refers to symptoms that occur after a SARS-CoV-2 infection and cannot be explained by another diagnosis.

Symptoms may include brain fog, fatigue, cognitive difficulties, breathlessness, sleep disturbances and problems with everyday activities. These symptoms may last for months or even years.

Research has also suggested that brain inflammation may persist even after the virus is no longer detectable.

Some people improve over time, while others experience prolonged illness that affects their ability to lead routine lives.