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.

CFor years, polycystic ovary syndrome (PMOS) has been characterised with irregular periods, excess hair growth, infertility, and weight gain. But doctors have increasingly been emphasising that it is a far more complex condition.

With metabolic conditions like insulin resistance, dyslipidaemia, fatty liver, and increased risk of diabetes forming an important part of the diagnosis, the condition has been rightly re-termed as Polyendocrine Metabolic Ovarian Syndrome (PMOS).

When the metabolic symptoms of PMOS came into focus, a a newer class of medicines, GLP-1 receptor agonists like semaglutide, began attracting attention.

Drugs like Ozempic and Wegovy were developed primarily for diabetes and obesity, not as universal treatments for PMOS.

Yet their ability to help lose weight and improve metabolic health has raised an important question: are GLP-1 drugs actually changing how doctors treat PMOS, or are they simply becoming another tool for managing obesity and insulin resistance in women who also have PMOS? According to experts, the answer is not that simple.

As September is PMOS Awareness Month, we take a closer look at how GLP-1 weight loss drugs are changing PMOS treatment.

GLP-1 Drugs Target The Metabolic Side of PMOS

HealthandMe spoke to Dr. David Chandy, Director of the Department of Endocrinology and Diabetology at Sir H. N. Reliance Foundation Hospital, Mumbai, who said that PMOS does not present identically in every woman.

“GLP-1 drugs are changing the treatment of the metabolic component of PMOS, rather than becoming a treatment for every aspect of PMOS. PMOS is not a disease with one presentation. Some women are lean, some have significant obesity, some predominantly have menstrual irregularity or excess hair growth, while others have marked insulin resistance, prediabetes or diabetes.”

Talking to HealthandMe, Dr. Sujith Ash, Consultant Obstetrician and Gynecologist at P. D. Hinduja Hospital & Medical Research Centre, Khar West, Mumbai, similarly stressed that PMOS needs to be understood as a broader metabolic and reproductive condition.

“What you first need to understand is whenever we are thinking about PMOS, it is a huge umbrella under which a lot of organs are implicated. So, it is not just the period-related issues that we are dealing with, we are also dealing with liver implications where your metabolism is affected, memory and exhaustion, and insulin resistance.”

Dr. Trupti Prasad, Endocrinologist at LH Hiranandani Hospital, told HealthandMe that the shift in understanding PMOS as a metabolic disorder is important when considering GLP-1 drugs.

She said, “As we know, there is a change in the name of PMOS to PMOS. It's now more considered as a metabolic disorder rather than just focusing on the ovaries and reproductive functions.”

She added that insulin resistance is one of the central mechanisms involved in PMOS and can have consequences beyond reproductive health.

“GLPs are definitely one of the main core pathology, pathophysiology of PMOS is the insulin resistance. So one of the main mechanisms by which GLP would help here is insulin resistance and weight reduction. But insulin resistance comes with complications like dyslipidemia, cholesterol disorders and even fatty liver.”

Also read: Weight Loss Surgery May Improve Irregular Periods And Other PMOS Symptoms

Having PMOS Does Not Automatically Mean You Need Ozempic Or Wegovy

One of the biggest concerns surrounding GLP-1 drugs is the perception that a woman with PMOS and excess weight should automatically be prescribed one. Experts warn against this strategy of treatment.

“Having PMOS alone is not an indication to start a GLP-1 drug.” Chandy said. “The first question should be whether the woman has overweight or obesity significant enough to justify medical treatment according to accepted obesity-treatment criteria.”

He said GLP-1 treatment becomes more relevant when excess weight is accompanied by metabolic complications.

“I would particularly consider it when there is significant excess weight or central obesity with problems like insulin resistance, prediabetes, type 2 diabetes, fatty liver, dyslipidaemia or other weight-related complications, especially when lifestyle measures alone have not achieved sufficient results.”

Conversely, she said a woman with lean PMOS or someone seeking to lose a small amount of weight for cosmetic reasons should not automatically be placed on semaglutide.

Prasad said doctors also use BMI and the presence of metabolic complications when considering these medications.

She also noted that Indian thresholds can differ from Western obesity criteria because metabolic diseases can occur at lower BMI levels in Indian populations.

“We use a cut-off of 25 with one comorbidity or above a 27 BMI irrespective of comorbidity. So the patient with this criteria of a BMI of 25 and has a PMOS obviously would go for the GLP-based therapies.”

Ash said assessment should go beyond weight alone. He says, “The other thing would be insulin resistance. We ask for a fasting insulin level in these patients along with the sugars and the cholesterol and the lipid profile basically, your fasting blood sugar, your HbA1c.”

Also read: Thin Outside, Fat Inside: Why A Slim Body May Still Hide Metabolic Health Risks?

Effects Of GLP-1 Drugs On Other Symptoms Of PMOS

Weight loss is currently the most established effect of GLP-1 drugs in this context. But researchers and clinicians are also interested in whether the improvement in metabolic health can translate into changes in other features of PMOS.

Dr. Chandy said the evidence is strongest for metabolic outcomes like weight reduction and insulin resistance. There are also signals of reproductive benefits, although the evidence is not equally strong for every outcome.

Dr. Chandy said, “There is encouraging evidence that menstrual cycles may become more regular. Some studies show improvements in sex hormone-binding globulin and modest reductions in androgen levels.”

However, he cautioned against treating these findings as established evidence that GLP-1 drugs directly treat every manifestation of PMOS. He added, “The effects on hyperandrogenism are inconsistent, and we do not yet have sufficiently strong evidence to say that GLP-1 drugs are treatments for hirsutism or acne.”

Dr. Ash explained why improving insulin resistance could have effects that extend beyond body weight. He said, “When I'm looking into the insulin resistance picture of PMOS, the major effect in the patient is not just the weight. It is the insulin that leads to the androgenic effects.”

He said insulin resistance can contribute to menstrual abnormalities and other symptoms. According to Dr. Ash, improving insulin sensitivity can reduce hyperinsulinaemia and potentially influence androgen levels and menstrual regularity.

“When GLPs are introduced in your body, GLPs will improve the insulin sensitivity. And once the hyperinsulinemia reduces, then that will help in suppressing the appetite. So, then weight balancing is better. Also, with the insulin resistance becoming better, the androgenic levels or the male hormone levels, which are increased in PMOS, PMOS, that is also better.”

Also read: From Insulin Resistance to Fertility: Understanding the Metabolic Side of PCOS

GLP-1 Drugs Vs Metformin

Metformin has long been used in PMOS treatment, particularly when insulin resistance and metabolic abnormalities need to be addressed. The arrival of GLP-1 drugs has therefore raised the question of whether they could eventually replace the older drug. Experts say that is not how the comparison should currently be viewed.

Dr. Chandy said both drugs are meant for different conditions. Metformin has decades of clinical use behind it, while GLP-1 drugs generally produce substantially greater weight loss.

The expert said, “Metformin has been used in PMOS for decades. It is inexpensive, we have extensive long-term safety experience, and it remains useful particularly for insulin resistance and metabolic abnormalities. GLP-1 drugs generally produce much greater weight loss than metformin. Therefore, in a woman with PMOS and significant obesity, a GLP-1 drug may have a much larger metabolic impact.”

Prasad similarly said GLP-1 drugs could offer an advantage when significant weight reduction is a major treatment objective. But she said it is too early to conclude that GLP-1 drugs will replace metformin.

Dr. Ash highlighted the fact that there is a depth of long-term evidence. He said, “The only deciding factor is that the effects are quicker in GLPs, but it is not something that I can do for a long period. Whereas metformin, I can do it for a longer period. And there are not enough studies which are based around the preconception and pregnancy aspects along with GLPs, which are there with metformin.”

Also read: Meet Louise Brown- The World’s First IVF Baby

Could Better Metabolic Health Improve Fertility?

One of the most intriguing parts of the GLP-1-PMOS conversation is fertility. Some women report that their periods become more regular after losing weight on GLP-1 drugs.

For women whose PMOS is associated with insulin resistance and irregular ovulation, this can improve the hormonal environment needed for ovulation. But experts caution against interpreting this as proof that semaglutide itself is a fertility drug.

Chandy explained that improving insulin resistance can improve reproductive effects. He said, “When a woman with PMOS loses significant weight and insulin resistance improves, insulin levels fall. High insulin levels can stimulate the ovary to produce more androgens and can interfere with normal follicular development and ovulation.”

There may be biological effects of GLP-1 signalling on reproductive issues as well, but Chandy said the clinical significance of these findings remains uncertain.

“There may also be direct effects of GLP-1 signalling on the reproductive system and the ovary, and there is interesting experimental research in this area. But clinically, I think it is premature to say that semaglutide is directly stimulating fertility.”

Women With PMOS Trying To Conceive & GLP-1 Drugs

This is where the difference between improving metabolic health before pregnancy and taking a GLP-1 drug during pregnancy becomes important. Prasad said this preconception can influence pregnancy outcomes.

“Pre-pregnancy parameters are very important in deciding upon what complications arise during the pregnancy. So ideally a normal body weight before pregnancy, even HB1C control should be less than 6.5, normal blood pressure, that is what we look for once a person goes for pregnancy.”

She said GLP-1 treatment can help women before conception, but the medication needs to be stopped before pregnancy. She said, “We have to stop at least two months prior to a planned pregnancy. So current data is not there for use during the pregnancy.”

Chandy similarly said GLP-1 drugs may have a role as a preconception metabolic intervention, rather than a pregnancy or fertility treatment. He also addressed the issue of discontinuing treatment.

Dr. Chandy said, “Another important issue is weight regain. Once GLP-1 therapy is stopped, appetite can increase again and some weight may return. So we need a long-term plan involving nutrition, physical activity and, where appropriate, other metabolic treatments rather than simply stopping the injection and hoping that the benefit remains permanently.”

As GLP-1 drugs become increasingly popular, doctors say one of the biggest risks is reducing a complex condition to a prescription for weight loss. Chandy said PMOS remains a lifelong reproductive and metabolic condition and GLP-1 drugs do not cure it. He also cautioned against viewing GLP-1 drugs as fertility medications. He said for women with PMOS and anovulatory infertility, established fertility treatments remain important.

He said, “The second misconception is that these medicines are fertility drugs. Some women certainly notice more regular periods and may start ovulating after significant weight loss, but that actually means that pregnancy can become possible unexpectedly. Women need to be counselled about contraception because these drugs should not be used during pregnancy.”

Ash said patients also need to understand that medication alone cannot substitute for sustained lifestyle changes.

“The entire idea of using any of the GLPs is that in that few months that we are doing the GLPs, you have to make sure your lifestyle changes even more disciplined, more religious and you follow that lifestyle. So the important part is forming the lifestyle as a habit which will continue for a longer period.”

Prasad stressed that the metabolic component of PMOS requires long-term attention rather than a short course of treatment.

“I want patients to understand that PMOS, as the name suggests, it's a metabolic complication which remains within the person throughout their life. It's not only about the ovaries, not only about the irregular periods or about the infertility issues. It's something which starts maybe like in a young age and it remains with you throughout your life.”

For the first time, the number of centenarians in Japan has exceeded 100,000. According to the latest figures from the health ministry, the country now has 107,677 people aged 100 and above, of whom 88% are women.

The oldest woman is Kishimoto Fuyo, a 114-year-old from Kyoto City, while the oldest man is Kato Hikaru, a 112-year-old from Kumamoto.

Health Minister Kenichiro Ueno told reporters he was “delighted that so many people are living long, healthy and active lives”. Citing progress in medicine and technology behind the long life, Ueno also warned about the challenge of maintaining a sustainable social security system.

Why Is Japan A Super-Ageing Society?

The long lives of Japanese people may be attributed to several factors, including genetics, a healthy diet and an active lifestyle.

The island nation’s cuisine predominantly consists of fish, vegetables and rice, with less saturated fat than many Western diets. Older people also regularly walk, use public transport, cycle and stretch.

However, Japan’s ageing population is linked to two major demographic trends: low birth rates and longer life expectancy.

Fertility falling below the replacement level means fewer younger people are entering the population, while improvements in healthcare allow people to live longer.

To curb the falling fertility rates, the government in 2023 launched programs aimed at increasing the birth rate, including a 3.5-trillion-yen (US$22.5 billion) increase in family-policy spending.

However, the country's total fertility rate still dropped to a record low of 1.14 in 2025, far below the 2.1 children needed to maintain the current population.

On the other hand, there were 153 people aged 100 or older when centenarian surveys began in 1963. The number exceeded 1,000 in 1981 and surpassed 10,000 in 1998, according to the Health and Welfare Ministry.

Also read: Unusually High Cancer-Fighting Immune Cells Could Explain Why Some People Live Beyond 100: Study

What Are The Challenges Of A Super-Ageing Society?

The World Health Organization defines “super-ageing” societies as countries where more than 20% of the population is aged 65 or older.

As the proportion of older adults grows relative to the working-age population, population ageing can place pressure on healthcare systems, economies and social support structures. It can also contribute to challenges such as pension pressures, labor shortages and increasing demand for long-term care.

An ageing population can increase the need for continuous medical care, caregiving and social support, due to

• Chronic disease burden of heart disease, diabetes, cancer and cognitive
• Resource strain, where Hospitals and nursing homes face shortages of specialized geriatric care personnel and integrated support services.
• Social isolation, where loss of community engagement and inadequate public transportation or age-friendly housing can increase vulnerability.
• Elder mistreatment: Social and family abuse, alongside systemic ageism, can undermine the dignity and safety of older citizens.

Read More: Normal Ageing or Alzheimer's? Doctors Explain Six Key Differences to Watch For'

Ageing Is Becoming A Global Challenge

Japan’s demographic shift is part of a broader global trend. According to WHO, by 2030, one in six people worldwide will be aged 60 or older. The number of people aged 60 and above is projected to rise from 1 billion in 2020 to 1.4 billion by 2030.

By 2050, the global population aged 60 and older is expected to reach 2.1 billion. The number of people aged 80 or older is also expected to triple between 2020 and 2050, reaching 426 million.

By 2050, two-thirds of the world’s population aged over 60 is expected to live in low- and middle-income countries.

Population ageing therefore has implications not only for how long people live, but also for healthcare, caregiving, social support and the size of the working-age population.

A commonly used antibiotic for pneumonia, urinary tract infections (UTIs) and certain skin infections has been linked to higher odds of death in adults, according to a new study.

The antibiotic, cefepime, is a cephalosporin that is relatively stable against AmpC β-lactamases, enzymes produced by some bacteria that can contribute to antibiotic resistance.

Concerns about a possible link between cefepime and mortality have been raised for years. A new systematic review and Bayesian meta-analysis has now re-examined the evidence from randomized clinical trials.

What Did The Study Find?

The study, published in JAMA Network Open, analyzed 110 randomized clinical trials involving 22,608 patients who received either cefepime or another β-lactam antibiotic.

Researchers found a 94.4% posterior probability that cefepime was associated with higher odds of death compared with other β-lactam antibiotics. Death occurred in 6.6% of patients treated with cefepime and 6.2% of those in the comparison groups.

The mortality signal was concentrated in adults, while the analysis did not find evidence of increased mortality in children. Researchers also found higher probabilities of harm across several clinical indications and with cefepime doses of 2 grams or more every 12 hours.

The highest probability of increased mortality was seen among patients treated for febrile neutropenia, at 96.1%.

Also read: 98 Years After Penicillin, Are We Running Out Of Effective Antibiotics?

Why Is Cefepime Safety A Concern?

Cefepime remains an important antibiotic used to treat serious bacterial infections, including pneumonia, UTIs, skin infections and febrile neutropenia.

Its current FDA-approved uses also include certain complicated intra-abdominal infections when used with metronidazole.

One concern with cefepime is neurotoxicity. The drug's prescribing information warns about neurological reactions, particularly in patients with kidney impairment when the dose is not appropriately adjusted. Reported reactions can include confusion, encephalopathy, myoclonus and seizures.

The question of whether mortality is directly caused by cefepime, however, remains unresolved.

An accompanying commentary in JAMA Network Open argued that the mortality findings may be related to dosing and drug exposure rather than cefepime itself.

The drug is typically administered via injection by healthcare providers in a clinical setting. Severe side effects may include confusion, decreased consciousness or seizures, especially in older patients and those with kidney problems, among many other common symptoms, according to Mayo Clinic.

Cefepime And The Earlier Mortality Debate

Read More: Nearly All Countries Overuse Antibiotics; 60% Still Use WHO-Discouraged Drugs: The Lancet

Concerns about cefepime's safety are not new. A 2007 meta-analysis reported a 26% higher relative risk of death among patients receiving cefepime compared with other β-lactam antibiotics.

The FDA subsequently analyzed a larger set of clinical trials and reported no statistically significant difference in mortality between cefepime and comparator antibiotics.

However, the researchers have also rated the overall certainty of evidence as moderate. They downgraded it because of differences between studies and possible publication bias, including 25 unpublished trials supplied by the US Food and Drug Administration that showed results in the opposite direction from the published literature.