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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GLP-1 drugs have been become increasingly popular for obesity and type 2 diabetes. But it may also have a beneficial effect on your lungs. New research presented at the European Respiratory Society (ERS) Congress in Barcelona suggests that people with asthma who were prescribed GLP-1 receptor agonists, particularly semaglutide, experienced significantly fewer asthma attacks.
But the important question is - are these drugs directly affecting asthma biology, or are people simply getting their asthma in control because they lose weight?
The study does not provide that answer. In fact, researchers and independent experts say clinical trials are needed before GLP-1 drugs can be considered a treatment for asthma.
Researchers led by Professor Chloe Bloom of Imperial College London’s National Heart & Lung Institute analysed UK electronic health records in four parallel studies.
Each study included around 20,000 to 22,000 people who had started a GLP-1 receptor agonist or a different type of diabetes medicine called a sulfonylurea.
The researchers looked at people with asthma and COPD and compared the frequency of acute respiratory attacks after treatment. The strongest result was seen with semaglutide.
Among people with asthma, semaglutide use was linked with nearly 40% fewer asthma attacks, while among people with COPD, it was linked with about a 20% reduction in flare-ups. The effect appeared stronger among people with more pronounced asthma.
Professor Bloom said, “The effect was strongest with semaglutide especially in people with asthma, where use of semaglutide appears to be associated with nearly 40% reduction in asthma attacks. Semaglutide also led to a 20% reduction in COPD flare ups.”
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Obesity itself is strongly associated with asthma. Excess body fat can affect lungs, increase inflammation and as well as immune response.
Dr. Shehla Shaikh, Consultant Endocrinologist, Saifee Hospital, Mumbai told HealthandMe, “People who are obese have a higher risk of developing asthma and often have asthma that is more frequent or more severe. When people lose weight the pressure, on the lungs decreases breathing becomes easier. Inflammation goes down. That may be why some people who use GLP-1 medicines say they have asthma attacks. However new research suggests that the story may not end with weight loss.”
So, if someone with obesity and asthma takes semaglutide, loses weight and subsequently has fewer attacks, the improvement may simply be a consequence of the weight loss.
Dr Vimal J. Pahuja, Associate Director, Dept of Medicine, Metabolic Physician & Diabetologist, Dr L H Hiranandani Hospital, spoke to HealthandMe, to explain more factors that could influence asthma flare-ups: “Obesity itself can make asthma worse. Extra weight around the chest and abdomen can reduce lung expansion and increase the effort needed to breathe. Obesity is also linked with acid reflux, sleep apnoea and a background state of inflammation, all of which can worsen asthma. Therefore, when a person loses meaningful weight on a GLP-1 drug, it is quite reasonable to expect fewer symptoms and possibly fewer attacks.”
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Even though research has not reached there yet, could there be a possibility GLP-1 drugs could have a beneficial impact on asthma? If yes, this could spark hope for the possibility that the drugs could have effects on airway inflammation that are partly independent of weight loss.
Dr. Pahuja explained, “GLP-1 receptors are also found in the lungs. Laboratory studies suggest that activating these receptors may calm inflammatory signals, reduce excess mucus and make the airways less reactive. Animal studies have shown reductions in several immune pathways involved in asthma, including signals that normally attract inflammatory cells into the lungs.”
He continued, “This is scientifically exciting because obesity-related asthma often behaves differently from the typical allergic asthma seen in younger patients. Early human studies are also encouraging. People with both diabetes and asthma who started GLP-1 medicines appeared to have fewer asthma flare-ups than those taking some other diabetes treatments. Importantly, some of this benefit remained even after researchers accounted for weight and blood-sugar changes. However, this does not mean GLP-1 drugs are asthma medicines. They should not replace inhalers or standard asthma treatment.”
The research was observational and based on medical records, rather than a randomised clinical trial. That means researchers observed what happened to people who received different medicines but did not randomly assign the treatments.
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Professor Bloom herself cautioned: “The findings from this study are encouraging, but they should not change treatment decisions on their own. People with asthma or COPD should not start GLP-1 receptor agonists specifically for their lung condition outside current prescribing guidance.”
Experts caution that despite promising outcomes of GLP-1 drugs, more research and clinical trials would be needed to prove that weight loss medicines have effects that transcend weight loss and diabetes management.
Dr. Shaikh concluded, “GLP-1 receptors are part of biological pathways that are linked to inflammation and metabolism. Scientists are studying whether GLP-1 drugs could directly affect inflammation in the airways or reactions that help cause asthma. The evidence is still growing, and it is too early to say that GLP-1 drugs really change the underlying biology of asthma.”
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If you regularly drink your tea or coffee “very hot,” you may be at three times higher risk of developing a type of esophageal cancer, according to a new study.
The team found that drinking hot beverages at very high temperatures may increase the risk of esophageal squamous cell carcinoma (SCC), which forms in the mucosal lining of the food pipe.
Studies in Asia, Africa, South America and the Middle East have consistently shown that drinking tea or mate (a herbal drink) at very high temperatures (around 70°C) increases esophageal cancer risk. However, evidence has been limited for drink temperatures typically consumed in Western populations.
To explore this, a team at Oxford analyzed data from around 980,000 UK adults and tracked their health records for more than 10 years to see whether they developed esophageal SCC.
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Compared with people who reported drinking their beverages “warm,” those who preferred their drinks “hot” had nearly twice the risk of esophageal SCC, while those who drank them “very hot” had a three times higher risk.
The findings “add to existing evidence that drinking very hot drinks could increase the risk of esophageal squamous cell carcinoma,” said Dr Keren Papier, lead researcher and senior nutritional epidemiologist at Oxford Population Health.
But does the beverage matter? No, the study did not find that consuming tea and coffee increased the risk of esophageal SCC. Instead, the risk was associated with the temperature of any hot beverage consumed.
“Our findings suggest that reducing drink temperature in populations where tea and coffee are frequently consumed could offer an important means of SCC prevention,” the researchers said.
It is unclear how higher drink temperatures may affect esophageal cancer risk. However, existing evidence suggests that very hot drinks may damage the lining of the esophagus, which, over time, can increase the chance of cancer.
The International Agency for Research on Cancer (IARC) also classifies drinking very hot beverages above 65°C as “probably carcinogenic” to people.
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The esophagus is a long, hollow tube that helps move swallowed food from the back of the throat to the stomach for digestion. Esophageal cancer is a malignant tumor in the food pipe and primarily affects people over the age of 55.
Lifestyle factors that may predispose a person to esophageal cancer include tobacco use, alcohol consumption, chronic acid reflux, obesity, and poor diet choices.
In the UK, there is a 1% lifetime risk of being diagnosed with esophageal SCC.
While the evidence linking hot drinks to cancer risk is still evolving, there are proven ways to reduce the risk of esophageal SCC.
“The most important ways to reduce the risk of this cancer type are not smoking and cutting down on alcohol,” said Fiona Osgun, head of health information at Cancer Research UK. Letting your tea or coffee to cool down a little before taking a sip, may be a good idea.
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An eclectic approach combines therapeutic frameworks according to an individual's symptoms, personality, developmental history, cultural and socioeconomic context, coping patterns and readiness for change—while keeping the therapeutic relationship and client participation central to recovery.
Psychological difficulties rarely exist in isolation. Anxiety, depression, relationship difficulties or trauma-related symptoms may be influenced by cognitive patterns, emotional regulation, personality, developmental experiences, relationships and social circumstances.
This is why psychotherapy cannot always follow a single therapeutic model. Eclectic therapy allows clinicians to draw from established approaches such as CBT, psychodynamic therapy, trauma-informed interventions, attachment-based approaches, emotion-focused work, mindfulness and behavioural strategies, based on the individual's clinical needs.
Importantly, eclectic therapy is not an arbitrary combination of techniques. Each intervention should have a clinical rationale and be linked to the individual's psychological formulation.
A clinical formulation considers more than symptoms or diagnosis. Personality factors, developmental history, attachment patterns, family dynamics, cultural expectations, socioeconomic circumstances and social identities may all influence how psychological distress develops and is maintained.
For example, the same anxiety symptoms may reflect perfectionism and conditional self-worth in one person, while being associated with attachment insecurity or previous adverse experiences in another.
Therapeutic readiness is also important. A client experiencing significant trauma-related dysregulation may initially require safety, stabilisation, psychoeducation and emotional regulation before deeper trauma processing is appropriate.
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People often arrive in therapy after already trying to manage their difficulties through self-help, lifestyle changes, support from family or friends, boundary-setting or previous therapy.
These efforts should not be dismissed simply because they were unsuccessful. Understanding what the person tried, what helped, what did not and why provides valuable information for case formulation and treatment planning.
Coping mechanisms such as avoidance, perfectionism, emotional suppression or reassurance-seeking may also have served a protective function at an earlier stage. Therapy therefore focuses not merely on labelling a behaviour as maladaptive, but on understanding its function and developing more adaptive alternatives.
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Relationship difficulties: A client who becomes highly distressed by emotional distance in relationships may require a combination of attachment-based psychoeducation, emotion-regulation strategies, cognitive and behavioural interventions, alongside exploration of earlier relational experiences.
Emotional disconnection: A high-functioning client who feels emotionally numb may require less emphasis on problem-solving and greater focus on emotional awareness, intellectualisation, experiential work and exploration of how emotions have historically been managed.
Cultural and social context: Anxiety or depression in a client navigating family expectations, sexuality, gender, financial pressures or minority stress cannot always be understood solely through individual psychological processes. Cognitive, emotional, relational and contextual factors may need to be addressed together.
The therapist provides clinical expertise, psychological formulation, therapeutic skills and appropriate challenge, but the client remains an active participant in the therapeutic process and recovery.
This may involve reflecting on patterns, practising skills between sessions, experimenting with new behaviours and communicating openly about what is or is not working. This responsibility should not be confused with blame; therapy is a collaborative process in which the therapist provides guidance while the client gradually develops greater agency in managing their psychological wellbeing.
The therapeutic relationship remains central. Respect, psychological safety and appropriate therapeutic challenge are particularly important in trauma-informed practice. Respecting a client's history does not mean agreeing with every decision; it means understanding the experiences and circumstances within which those decisions were made.
Eclectic therapy recognises that psychological difficulties are multidimensional and that individuals differ in their personality, history, circumstances, coping mechanisms and capacity for change.
The central clinical question is therefore not simply which therapy works? but which therapeutic approach is most appropriate for this individual, for this difficulty, at this stage of treatment?
When grounded in clinical formulation and evidence-informed practice, eclectic therapy provides flexibility without losing therapeutic structure—allowing treatment to address the person rather than simply the presenting symptom.
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