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.

The most frustrating skincare experience is breaking out a week after using a new product. Niacinamide serum is the most common one that people blame when it happens. But the real question is: does Niacinamide cause purging? The answer is no, but understanding what happens in your skin when you introduce it can help you.

A well-formulated Niacinamide Serum at the right concentration is very gentle on the skin.

And pairing it with a Niacinamide Moisturizer helps your skin adjust if you are using it for the first time.

What Is Skin Purging and How Is It Different from Breakouts

Skin purging is the result of an active ingredient accelerating your skin's natural cell turnover cycle. Your skin renews itself every 28 days. Retinol, AHAs, and BHAs speed up this process, which pushes microcomedones, trapped sebum, and dead cell buildup up to the surface faster.

Your skin may appear like it is experiencing a sudden flare-up of pimples, but it is your skin clearing all the buildup in one go. True purging:

• Happens only with ingredients that increase cell turnover
• Appears in the same areas you normally break out
• Resolves within four to six weeks
• Involves small whiteheads and blackheads rather than deep cysts

A regular breakout appears in new areas with any product and does not follow the same predictable timeline. Understanding this difference is important before you blame any ingredient.

Does Niacinamide Cause Purging?

Dermatologists say no, and the reason comes down to how niacinamide works at the biological level. Purging occurs only when an ingredient accelerates cellular turnover, forcing the skin to shed faster to clear hidden congestion.

Niacinamide is a form of Vitamin B3, and its action is fundamentally different. It works in the following manner:

• Regulates sebum production through the sebaceous glands
• Strengthens the skin barrier by supporting ceramide production
• Niacinamide reduces redness and inflammation caused by acne
• Stops the transfer of melanin so that pigmentation reduces

Why Niacinamide Is Less Likely to Trigger Purging

No Cell Turnover Acceleration

Can niacinamide cause purging? Purging occurs when the old skin cells are shed, and new ones form at a faster pace. Niacinamide has no effect on this process. It works on controlling oil and improving barrier function. It does not work on exfoliation or renewal rate. There is no mechanism through which Niacinamide could cause purging without accelerating cell turnover.

Regulates Sebum, Doesn't Exfoliate

Niacinamide signals the sebaceous glands to produce less oil over time, whereas salicylic acid dissolves the sebum inside pores, and AHAs dissolve the bonds between dead skin cells. It reduces the congestion that leads to breakouts. Niacinamide for pimples works by calming the conditions that create them.

Reduces Inflammation Instead

The anti-inflammatory action of Niacinamide calms the redness and swelling around active breakouts. So, does niacinamide cause pimples? Its inflammation-reducing properties make it the safest active for acne-prone skin, which you can introduce at any concentration between 5% and 12%.

What Could Actually Be Causing Your Purging

If you started a niacinamide product and broke out, here are the more likely reasons for it.

New Product Adjustment

Any new skincare product can cause a temporary adjustment period as your skin gets used to a new formula or ingredients. This is not purging, but your skin reacting to change. It settles within one to two weeks if the formula is compatible with your skin.

Reaction to Other Formula Ingredients

Many niacinamide serums contain additional actives, such as AHAs, BHAs, Retinol, or exfoliating enzymes, which increase cell turnover in your skin. If your Niacinamide serum contains these ingredients as well, the purging may result from them. So, always check the full ingredient list before blaming a reaction on any single ingredient.

Wrong Concentration for Your Skin

Using a 20% Niacinamide formula directly when your skin has never used actives before can cause irritation that looks like a breakout. It's your skin reacting to a concentration that it is not ready for. A safe way is to start between 5% and 10% and build up slowly to prevent flare-ups.

How to Add Niacinamide Properly to Your Skincare Routine

The chances of a reaction reduce a lot when you introduce Niacinamide correctly.

1. Patch test first: Take a small amount and apply it to your inner arm or jawline, and observe for any reaction in the next 24 hours before using it on your full face. Gentle ingredients can react differently on certain skin types, so you must do a patch test.

2. Start at a lower concentration: 5% to 10% is the best starting point if you are a beginner. Give your skin four weeks at this level before going with anything stronger.

3. Introduce one product at a time: If you add multiple new products all at once, you will never know which one is causing a reaction. Add Niacinamide on its own first and give it two to three weeks before introducing other active ingredients.

4. Apply after washing your face: Niacinamide works best when the skin is fresh. Apply it after your face wash and before your moisturizer so that it absorbs better into the skin.

5. Be consistent: The oil-regulating and pore-refining benefits of Niacinamide show only after four to eight weeks of daily use. So, you may not get the results if you stop using it abruptly because of an unrelated reaction.

Conclusion

If you are still wondering, does niacinamide cause purging? It does not. An increase in cell turnover results in purging, and Niacinamide does not work that way. The main reasons for breakouts can be your skin trying to adjust to a new product or another active ingredient in the formula. Higher concentrations can also be tough for your skin to tolerate, which may result in breakouts.

Researchers have found that up to 25 per cent more adults could be classified as obese, even if their body mass index (BMI) score falls under the normal category. As per the current rules, a BMI score of 18.5 to 25 is considered healthy, 25–29 is overweight, and 30 onwards is considered obese. Obesity can contribute to a long-term risk of serious illness, but according to an international team of experts, BMI may not be the most reliable measure for ascertaining obesity levels in an individual.

Why is BMI not a reliable parameter?

Researchers have found that adding the weight-to-height ratio and waist circumference could be a good way to ascertain unhealthy body fat levels. Fat, according to scientists, builds up in people who are not considered overweight or obese under the current rules, depending on where it is stored. Older bodies have a higher fat build-up around the waist, which, when combined with loss of muscle mass, means that there is no change in total weight. This means that the fat that accumulates, known as "skinny fat," does not always raise an alarm.

The new study from scientists at the University of Southern California analysed data from 5,642 adults in the US and discovered that a quarter of them had a normal BMI but actually met the obesity criteria. Furthermore, over 50 per cent of overweight people, according to their BMI, also met the updated obesity criteria. These findings, according to experts, suggest that millions of Americans with obesity-related health complications could be missing much-needed health interventions.

BMI is problematic because it does not evaluate body fat but reflects total body weight, including muscle and bone. Therefore, a muscular person is likely to have a high BMI but not much fat. However, a person with a normal BMI can have excess body fat, which can lead to complications later. The good news, experts say, is that these obesity-related issues can be addressed. Either lifestyle changes, medication, or both can be effective in reducing body fat levels and lowering the risk of future health problems. The sooner it is diagnosed, the better it is for long-term well-being.

Read more: Why 'Normal Weight' Doesn’t Always Mean Healthy

Does obesity risk increase with age?

Researchers estimate that 30 per cent of adults living in England aged 16 years and above are obese. This increases with age, with over 35 per cent of people aged 55 to 74 years living with obesity. Under the new rules, obesity would be defined as a BMI of 30 and above, or at least one elevated measure, such as a high waist circumference, a high waist-to-height ratio, or a BMI of 40 and above. Researchers have labelled these obesity subtypes as BMI-plus-anthropometric obesity.

What is an unhealthy waist circumference?

According to the NHS, an unhealthy waist circumference is 37 inches in men and 31.5 inches or above in women. An unhealthy waist-to-height ratio occurs when the waist circumference is half or more of a person's height. According to the British Heart Foundation, BMI is calculated by dividing weight by height squared. There are multiple BMI calculators available online. It is classified as follows:

1. Underweight – below 18.5
2. Healthy weight – 18.5 to 24.9
3. Overweight – 25 to 29.9
4. Obese – 30 and above

If BMI is in the overweight category, it is linked with a heightened risk of heart disease and incidents such as stroke or heart attack. If it falls within the obese category, the risks are higher. Underweight people are not exempt from risk, as they have a greater likelihood of developing long-term health problems.

Millions of Indians are increasingly turning to mental health apps to manage stress, anxiety, loneliness, and other emotional challenges. These digital platforms offer a range of services, from mood tracking and mindfulness exercises to AI-powered chatbots designed to provide conversational support that can feel similar to therapy.

The growing adoption of such apps comes amid a significant shortage of mental health professionals in India. Data from the National Mental Health Survey indicate that nearly one in ten Indian adults lives with a diagnosable mental health disorder, while more than 85 percent of people with depression do not receive adequate treatment. Other studies have also highlighted a large gap between the demand for mental healthcare services and the availability of trained psychiatrists, psychologists, and counselors, particularly in rural and underserved regions.

Against this backdrop, mental health apps position themselves as a convenient and relatively affordable way to access support anytime and from anywhere. However, researchers and mental health experts caution that the rapid rise of these platforms has also sparked concerns about data privacy, the clinical effectiveness of digital interventions, and the level of oversight and accountability surrounding AI-driven mental health tools. While some studies suggest that digital mental health programs can help reduce symptoms of anxiety and depression, experts emphasize that they should complement—not replace—professional care, especially for individuals with moderate to severe mental health conditions.

Also Read: India's Maternal Mortality Ratio Drops From 130 To 87 In Last 10 Years: Govt

How Mental Disorders Are Impacting Life Worldwide?

Mental disorders are on the rise worldwide, and nearly 1.2 billion lives are now affected by them. A recent study published in The Lancet has revealed this very crucial trend. The study was conducted by researchers at the Institute for Health Metrics and Evaluation (IHME) in collaboration with the University of Queensland.

This study shows that the number of people affected by the mental disorder has almost doubled since 1990. It also emphasizes the role of mental disorder in the case of disability, as the research suggests that it has crossed cardiovascular disease, cancer, and musculoskeletal conditions, leading to disability. Notably, the study has revealed that mental disorders affect people of different sexes and ages disproportionately.

The research was done on a massive scale from 1990 to 2023. The researchers studied the impact of mental disorder on both sexes, in 25 age groups, 21 regions, and 204 countries and territories.

Over the years, mental disorders have caused more and more mayhem in people's lives. Disability adjusted life years (DALYs) show the very impact of mental disorders on life. DALYs measure the health loss. It calculates the years lived with disability and years of life lost due to premature death.

According to this very measuring system, we can see that the mental disorder and its impact on overall life reached another zenith in 2023. That year, mental disorders alone caused 171 million disability adjusted life years (DALYs). This made mental disorder the fifth biggest contributor to total disease burden. Notably, in 2023, mental disorders had a 17 percent share of total life lost due to disability throughout the world.