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.

Many couples are battling infertility and are keen on opting for ARTs to conceive and fulfill the dream of parenthood. However, the country continues reeling under severe heatwave conditions. Currently, a large number of couples who are planning fertility treatments are becoming stressed regarding how heatwaves can impact IVF procedures and even the success rates. Patients frequently ask fertility consultants whether extreme outdoor heat can affect the IVF laboratory environment, embryos, sperm samples, or even egg quality. However, there is no need to panic, as labs are designed to function even under highly controlled conditions throughout the year, and it is possible for couples to conceive successfully.

In an interaction with Health and Me, Dr. Aswati Nair, Fertility Specialist, Nova IVF Fertility, Rajouri Garden, Delhi, spoke about how extreme temperatures can affect the IVF process and what the consequent impact is on the outcome.

Read more: Heatwaves And Toxic Air Create A Growing Health Crisis In Delhi

Does a heatwave affect the IVF lab?

Usually, all the IVF labs have Air Handling Units (AHUs), which maintain the internal condition of the lab throughout the year at the same condition and temperature, and all the parameters are maintained throughout the year with the help of this equipment and gadgets. So, the internal environment of the lab does not get affected by an external heatwave. Understand that the temperature-sensitive procedures that are carried out inside the IVF lab, such as handling eggs, sperm, and embryos, are performed in a controlled setting and are monitored constantly. Hence, external heatwaves do not directly impact the IVF lab environment or the development of embryos. But only from the patient's perspective; they need to be hydrated and careful when there is scorching heat outside.

Too much heat can lead to dehydration, weakness, fatigue, dizziness, and stress, which can impact the patient’s health during fertility treatment. Women undergoing IVF cycles are put on hormonal medications, and staying hydrated is necessary for everyone. It is the need of the hour for the patients to take charge of their well-being right away!

Read more: Heatwave In India: Temperatures Continuously Rising; Stay Hydrated, Says PM Modi

Precautions to take

The precautions that patients can take are to stay well-hydrated and adhere to a balanced diet with lots of fruits and seasonal fruits like watermelon and muskmelon, which can improve hydration. They can have coconut and lemon water and avoid beverages, carbonated drinks, caffeine, and alcohol. They can follow these crucial tips to stay healthy during the heatwave. Patients should be sure to follow the guidelines given by the fertility consultant.

Even if the heatwaves can lead to discomfort, it doesn’t affect the functioning of modern IVF laboratories. By paying attention to various factors such as hydration, nutrition, and self-care, patients can safely continue their fertility journey even if there is extreme heat outside.

Mrs. Radha Sharma, 78, was brought to the hospital with sudden confusion, irritability, and restlessness. She had no fever, no pain, and no typical urinary complaints. Her family worried it could be dementia or a brain-related issue. However, a simple urine test revealed the real cause— a urinary tract infection (UTI). With timely treatment, fluids, and care, she recovered within a few days. This is a common but often overlooked reality—UTIs in older adults don’t always look like UTIs.

In another case, 72-year-old Mr. Pankaj Verma had repeated UTIs over a year. Each time, antibiotics provided temporary relief, but the infection kept returning. On further testing, doctors found an enlarged prostate that was preventing his bladder from emptying fully. Once this was treated, his infections reduced significantly.

These examples show an important pattern: in the elderly, UTIs are often missed, misunderstood, or keep recurring because the root cause is not addressed.

Why Are UTIs So Common In Older Adults?

As we age, the body goes through changes that make infections like UTIs more likely. In women, menopause leads to a drop in estrogen levels. This weakens the natural lining of the urinary tract, making it easier for bacteria to grow. Women also have a shorter urinary passage, so that bacteria can reach the bladder more easily.

In men, an enlarged prostate is a common issue. It can block the flow of urine, causing some urine to remain in the bladder. This leftover urine becomes a breeding ground for bacteria. Other common reasons include weaker immunity, conditions like diabetes, urinary incontinence, use of catheters, reduced movement, and dependence on caregivers for hygiene.

Symptoms Are Not Always clear

Unlike younger people, elderly individuals may not complain of burning urine or urgency. Instead, the signs can be subtle and confusing, such as:

• Sudden confusion or unusual behavior
• Increased falls
• Weakness or tiredness
• Loss of appetite

These symptoms are often mistaken for ageing or dementia, which can delay treatment.

Men vs Women: What’s the Difference?

UTIs are more common in older women due to hormonal changes and bladder control issues. Many women also experience repeat infections. In men, UTIs are less common but usually more serious. They are often linked to problems like prostate enlargement or urinary blockage, which need proper evaluation. Chronic illnesses play a big role. Diabetes, for example, increases the risk because excess sugar in urine helps bacteria grow. Poor sugar control also weakens the body’s ability to fight infections.

Conditions that affect bladder control, such as stroke or Parkinson’s disease, can also lead to incomplete emptying of the bladder, increasing infection risk.

Diagnosis Needs Careful Attention

Not every bacterium found in urine needs treatment. Many older adults have bacteria in their urine without symptoms—a condition called asymptomatic bacteriuria. Treating this unnecessarily can lead to antibiotic resistance. Doctors usually rely on urine tests, cultures, symptoms, and medical history before deciding on treatment.

Treatment: More Than Just Antibiotics

While antibiotics are important, they are only one part of the solution. Repeated courses without finding the cause often lead to recurring infections.

Treatment should also focus on:

• Drinking enough fluids
• Managing diabetes or other health conditions
• Treating prostate problems in men
• Avoiding unnecessary catheter use
• Reviewing medications that may affect bladder function

Early treatment is crucial. Ignoring symptoms can allow the infection to spread to the kidneys, which can be serious. Recurrent UTIs are common in the elderly. This can happen due to:

• Incomplete treatment
• Underlying problems like prostate enlargement
• Ongoing issues, such as incontinence or catheter use
• Antibiotic resistance

Prevention: Simple But Effective Steps

Preventing UTIs doesn’t always require complex measures. Small daily habits can make a big difference:

• Encourage regular water intake
• Avoid holding urine for long periods
• Maintain proper personal hygiene
• Manage conditions like diabetes well
• Limit catheter use
• Consider probiotics or cranberry products (after medical advice).

Caregivers play a key role in ensuring these habits are followed, especially for elderly individuals who need assistance. Immediate medical attention is needed if there is:

• Fever or chills
• Sudden confusion
• Blood in urine
• Lower back pain

UTIs in the elderly are common but often not straightforward. They may present differently, recur frequently, and require more than just antibiotics. The key is early recognition, identifying the underlying cause, and taking simple preventive steps. With the right care, recurrent UTIs can be reduced—helping older adults live healthier, more comfortable lives.

(By Dr. Sunita Goyal, Senior Consultant – Obstetrician and Gynecologist, Cloudnine Group of Hospitals, Ludhiana)

Systematic Lupus Erythematosus (SLE), also known as Lupus, is a multisystem autoimmune disease in which one's immune system attacks the body. It is most common in women of reproductive age; however, in rare cases, it can present in men and patients of any age.

Lupus Symptoms: More Than Just Joint Pain

Symptoms for SLE can range from unexplained fever for days to months, to oral ulcers, malar rash, photosensitivity (after exposure to sun), hair loss, headache, stroke, seizure, abnormal behavior (psychiatry lupus). A large group of patients experiences joint swelling, pain, and fatigue. If the kidneys are affected in Lupus patients, they can pass blood with their urine.

Their urine output also decreases; their legs swell, and there is swelling around the eyes. Involvement of the heart, brain, and pancreas is also not uncommon. Lupus is one of the causes of multiple unexplained pregnancy losses, especially in the second trimester, but with proper treatment and observation, many patients do well and have an uneventful pregnancy and childbirth.

Common Myths About Lupus

Some very prominent myths about SLE need to be debunked. Many think SLE is contagious and that only women can get it, when in reality, neither is true. Being an autoimmune disease means it cannot spread by contact, and it impacts both men and women, although the incidence rate of SLE is higher for women. Many also believe in the common misconception that it affects only joints, when in reality it is a multisystem disease that can affect the kidneys, heart, brain, skin, and lungs.

There is a common myth that pregnancy is impossible or unsafe for women with Lupus; however, many women with Lupus can conceive and experience safe and healthy full-term pregnancies under the right medical guidance. Kidney biopsy, which is a required test for treating Lupus, is often deemed unsafe, but it is a safe test and is required to decide the stage of the disease and treatment.

Lupus: Warning Signs

Some symptoms that can be a cause of alarm in SLE are rapid rising serum creatinine, new onset seizure or psychosis, sudden onset shortness of breath associated with chest pain, blood in cough with low oxygen saturation, acute confusional state with fever, vision changes, severe abdominal pain, unexplained severe anemia, severe thrombocytopenia (platelet count < 20,000).

Managing Lupus

For accurate diagnosis and treatment, one needs a rheumatologist's consultation. Rheumatologists will decide the plan of treatment to manage symptoms, reduce inflammation, prevent flares of the disease, and minimize organ damage. Lifestyle measures like avoiding Sun exposure, quitting smoking, lowering stress, and engaging in some low-impact physical activities help patients to minimize the disease burden.

There is very little awareness about Lupus in society, and due to varied presentations and symptoms, patients often consult with multiple doctors of different specialties before consulting with rheumatologists. We need to push for more awareness in society about less talked-about ailments like Lupus, which needs efficient intervention and management, as it is a lifelong condition. Talking about it also helps reduce stigma and bust myths around it. Late diagnosis and delay in treatment can cause significant morbidity, disease progression, and mortality. With early diagnosis and optimal treatment.

Holistic care is possible, which goes a long way in helping individuals manage autoimmune conditions like Lupus

(By Dr Niharika Gill, Rheumatologist, Lilavati Hospital and Research Center, Mumbai)