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.

On International Men's Day, we shift our focus on men's health and why is it important to talk about it. Time and again experts, doctors, and studies have shared how men generally visit GPs less than women. As per the NIH, US, the consultation rate is 32% lower in men than women. The difference is often attributed to a combination of women being more willing to admit sickness and seek help, while cultural factors and barriers for men keep them away from seeking help. However, not anymore, because both sexes require help when they need, especially when it is about their health.

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As per a 2024 study published in the Journal of Clinical Investigation, about 5.7 million men could be living with an autoimmune disease that they do not even know about. The disease in men are often overlooked, all thanks to the social barriers.

Sex chromosomes play a key role in predisposing men or women to an autoimmune disease. Females have XX chromosomes, while male have XY chromosome and each chromosome carries gene sequence, which means specific pieces of DNA. Since X chromosome carries a bunch of gene related immunity,, having two of them could explain why women often have a higher rate of autoimmune diseases.

However, men are less likely to book time with their doctors, which could impact the discrepancies between sexes. They could thus often be undiagnosed or could flag their symptoms only when the disease has progressed.

Four Autoimmune Diseases Men Should Be Aware Of

Psoriasis

This is an inflammatory skin condition which affects both men and women. However, studies including the one published in 2023 in the International Journal of Women's Dermatology have suggested that men could develop this condition near their genitals and butt than women.

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Ankylosing Spondylitis or AS

As happens due to the inflammation of the spine's joints and ligaments and could cause back pain and stiffness. While the condition is rare in itself, it could affect men more than women, that too at a younger age, usually below 40. A South Korean study from 2018, published in Scientific Reports, AS was 3.6 times more prevalent in men than women.

Type 1 Diabetes

The 2018 report by the Centers for Disease Control and Prevention, (CDC), US, provides data that type 1 diabetes may be slightly more in common in men than women. Though, other studies have been a mixed bag. Unlike type 2 diabetes, type 1 is an autoimmune disease, which means, here immune system attacks are specialized. What men should know is that both types of diabetes could up their risk of erectile dysfunction (ED) due to persistently high blood sugar, which could harm their nerves and blood vessels.

A 2016 study published in the International Journal of Impotence Research found that nearly 60% of 151 men being treated for type 1 diabetes had mild ED.

Inflammatory Bowel Disease (IBD)

The most common forms are Crohn's disease and ulcerative colitis, that take hold of digestive system. Chronic inflammation in the gut spikes the risk of colorectal cancer, which is one of the leading cause of death in men between 20 to 49 of ages. In fact, a 2023 study published in the journal Cancers noted that men with IBD faced a higher risk of developing colorectal cancer than women with IBD.

Not every medicine carries the same level of risk. Some drugs can trigger reactions that are severe or even life-threatening. When that possibility exists, the manufacturer is required to place a special notice inside the prescribing information. This highlighted section is known as a black box warning.

A black box warning is meant to draw clear attention to the most serious dangers linked to a drug. Many medicines fall under this category. Still, having the warning in place does not automatically make the treatment unsafe. When a drug is used correctly and monitored by a trained professional, the benefits may outweigh the risks.

The sections below outline what an FDA black box warning means, why a medicine might receive one, and how it may influence your treatment plan.

What Is An FDA Black Box Warning And What Does It Signify?

A black box warning is the strongest caution that the FDA can attach to a prescription drug. You might also see it described as a boxed warning.

The presence of this warning does not mean a person should never take the medication. Instead, it alerts doctors and patients to serious potential harm. This information helps clinicians decide who is an appropriate candidate and under what circumstances the drug should be used.

Many medicines with boxed warnings remain the best or only option for certain conditions.

How Serious Is A Black Box Warning?

A drug receives this type of label when it has been linked to outcomes such as permanent injury, hospitalisation, or death. These warnings should be read carefully, and patients should discuss them openly with their healthcare provider.

Doctors follow specific precautions when prescribing drugs that carry this label to minimize unnecessary risk.

Where Can I Find A Drug’s Black Box Warning?

The warning sits at the very top of the medication’s official package insert. Its placement is deliberate so it stands out immediately. The text is printed inside a bold black border, which is how the term “black box” took hold.

You may not always receive the full package insert from the pharmacy. However, you might receive a medication guide if the drug is considered high-risk. These guides describe proper use and highlight major side effects. You can also look up medication guides online.

Information about boxed warnings is available from multiple sources. The FDA website, the drug manufacturer’s website, and medical reference sites used by clinicians all include these details.

How Does A Drug End Up With A Black Box Warning?

Every prescription drug must go through extensive testing before it reaches the market. During this process, researchers aim to uncover risks that could require a boxed warning from the start. Even so, some side effects only appear once large numbers of people begin using the drug in everyday settings.

Because of this, most black box warnings are added after a medicine has already been approved. The FDA continues to monitor safety reports through MedWatch, a program where patients, physicians, and companies can report problems.

These reports are gathered in a database called the FDA Adverse Event Reporting System. When the agency notices a pattern of serious reactions, they investigate. If needed, they update the prescribing information and add a boxed warning so that future users are clearly informed.

People assigned female at birth live with hormone shifts throughout their lives. These chemical messengers guide nearly every system in the body. The swings linked to periods, pregnancy or menopause are easy to recognise, but many other factors can unsettle hormone levels.

The body produces more than fifty hormones through the endocrine system, and changes in any of them can signal a deeper health concern. Low insulin may point toward diabetes. Excess cortisol can influence weight gain. Other hormones, like melatonin, rise and fall through the day as part of normal rhythm. And the gradual drop in estrogen and progesterone as women approach menopause is also expected.

What Causes Hormonal Imbalance?

Puberty, pregnancy and menopause naturally reshape hormone activity. Beyond these, several conditions can disrupt normal patterns. Problems with the adrenal gland, thyroid disorders, eating disorders, congenital adrenal hyperplasia, Cushing’s syndrome, diabetes or PCOS can all change your hormone levels. Changes may also stem from stress, certain medicines, tumours, cysts or environmental chemicals.

Interest in hormones has grown recently. Earlier this month, the Food and Drug Administration agreed to remove the boxed warning on menopause hormone therapy after reviewing the evidence. The decision prompted fresh discussion among women considering treatment. Clinicians say many patients are reaching out with new questions, especially in an era filled with quick tests and supplements marketed as hormone balancers. It can be difficult to tell when testing is truly needed.

Warning Signs Of Hormonal Imbalance

As each hormone plays a different role, symptoms vary widely. These are some of the more frequent changes seen in people, as per UCLA Health.

1. Menstrual changes: Shifts in estrogen and related hormones can alter the monthly cycle. Periods may become heavier, lighter, irregular or go missing. Stress, diet and exercise can contribute as well, but hormonal swings remain a leading cause.

2. Hair changes: Hair often reacts quickly to hormonal shifts. Pregnancy can bring thicker strands, while imbalances may trigger hair thinning or hair growth in unexpected places. Excessive facial hair may suggest elevated androgens. Hair loss can point toward a thyroid concern.

3. Skin Changes: Hormonal shifts can influence skin colour, texture and oil production. Acne may flare during pregnancy due to rising progesterone. Darkened patches of skin may appear on areas like the neck, groin or beneath the breasts when estrogen or progesterone levels change.

4. Sexual and vaginal symptoms: Lower estrogen levels, especially with age, can reduce libido and cause vaginal dryness or pain during intercourse. Some women may experience vaginal atrophy when estrogen remains low for long periods.

5. Weight changes: Sudden weight gain or weight loss can reflect a hormonal issue. Many women notice weight gain after menopause. Thyroid disorders, PCOS and Cushing’s syndrome are also linked to changes in body weight.

6. Mood and sleep difficulties: Falling estrogen levels influence serotonin, a chemical important for stable mood. Low serotonin can contribute to anxiety, irritability or low mood. These disruptions often spill into sleep. Some women also report night sweats or trouble staying asleep.

7. Digestive issues: Estrogen and progesterone affect digestion. When these hormones shift, the gut may respond with bloating, constipation or diarrhoea. Some research has linked hormonal changes in people AFAB to irritable bowel syndrome. Many notice digestive changes around their menstrual cycle.

What To Do If You Suspect A Hormonal Imbalance

There is no single test that measures every hormone, and at-home kits only cover a few markers. The safest first step is to speak with your primary care doctor. They can look at your overall health and decide what evaluations are appropriate.

Diagnosis may include:

• A physical exam and review of your medical history
• Checking prescriptions or supplements that may influence hormones
• Blood, urine or saliva tests to measure specific hormone levels
• A pelvic exam to check for cysts or growths
• An ultrasound to look at the ovaries, uterus, thyroid or pituitary gland