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 Black Death swept across Eurasia and North Africa between 1346 and 1353, killing an estimated 30% to 60% of Europe's population.

Plague continued to recur in Europe over subsequent centuries, causing millions of deaths. Caused by Yersinia pestis, the same bacterium responsible for plague today, the Black Death was primarily associated with bubonic plague, although pneumonic plague also occurred.

Bubonic plague typically spreads through infected flea bites, while pneumonic plague affects the lungs and can spread between people through infectious respiratory particles during close contact. All forms can be fatal without prompt treatment, but antibiotics are effective when administered early.

India's 1994 Plague Outbreak

Although often associated with medieval history, plague continues to occur in parts of the world.

In 1994, India experienced an outbreak involving both bubonic and pneumonic plague, following heavy flooding and reports of exposure to dead rats.

“When the plague outbreak happened in India, I was one of the people who investigated it. The outbreak involved bubonic plague, which can be treated with antibiotics, and Surat also saw 64 to 68 cases of pneumonic plague. We identified the plague bacillus and traced its cycle in the surrounding wildlife. Plague surveillance in rats and other animals is essential to detect outbreaks early and take preventive measures,” Dr. N.K. Ganguly, former Director General of the Indian Council of Medical Research (ICMR), told HealthandMe.

There were 693 suspected cases that tested positive for Yersinia pestis antibodies and 56 deaths nationwide.

Surveillance, hygiene and timely treatment were essential to controlling the disease, said Dr. Amitabh Banerjee, an epidemiologist and former member of the Indian Armed Forces’ mobile epidemic investigation team. He investigated the 2002 pneumonic plague outbreak in Himachal Pradesh, which caused 16 cases and four deaths.

Plague Still Exists In Africa And The US

In the US, an average of about seven human plague cases are reported annually, mostly in rural areas of the American West, according to the Centers for Disease Control and Prevention (CDC).

The continued presence of Yersinia pestis in animal populations means the disease has not been eradicated.

“People think the plague is gone, it was something that occurred 500 years ago. It's not. It's here amongst us,” Simon Clarke of the University of Reading in the UK told the Associated Press. “Unless you get rid of those wild animals, which of course is not possible, then you're not going to get rid of the bacteria.”

Russia's Plague Scare: What We Know

Russia has completed checks following the October 2 death of 28-year-old laboratory worker Darya Shipilova in Siberia. Authorities have not confirmed plague as the cause, describing her illness as pneumonia of unknown origin. Nearly 5,000 samples reportedly showed no dangerous pathogens.

Reports of a second death linked to the plague was called "fake news" by Russia, and no plague outbreak has been confirmed in Russia. The WHO and US have requested Russia for more transparency regarding the cases.

Can Plague Be Eradicated?

Plague persists because Yersinia pestis circulates naturally among wild and domestic animals, including rodents, and their fleas. Eliminating human cases in one location does not remove the bacterium from these animal reservoirs.

Dr. Banerjee said plague can be deadly, particularly when it affects the lungs, but modern antibiotics are highly effective when treatment begins early.

“Plague cannot be eradicated because it is in wildlife, it is in rodents and all. So the only thing is hygiene and, with modern antibiotics, there should not be any panic,” he told HealthandMe.

Bubonic plague does not typically spread directly between people, while pneumonic plague can spread through infectious respiratory particles during close contact. Pneumonic plague can progress rapidly and requires urgent treatment.

Dr. Banerjee cautioned against assuming that a suspected case automatically signals a wider outbreak, noting that early diagnosis and appropriate antibiotic treatment are crucial.

Indian jewelery designer Saba Ali Khan, daughter of veteran actress Sharmila Tagore and cricketer Mansoor Ali Khan Pataudi, has opened up about her brain tumor diagnosis at the age of 27.

Speaking on her sister, actress Soha Ali Khan’s podcast, Saba recalled that her diagnosis came as a surprise, without common warning signs such as headaches or vision loss.

Dr. Mazda K. Turel, the neurosurgeon who treated her at Wockhardt Hospitals, Mumbai, told HealthandMe that people with brain tumors can be “walking, talking and functioning normally” despite having a potentially serious tumor. He explained why tumors can go unnoticed and which symptoms warrant medical attention.

How Saba Ali Khan Discovered Her Brain Tumor

Saba recalled fainting while out with a friend. After losing consciousness a second time, she took around 20–25 minutes to regain consciousness.

An MRI revealed a shadow in the third ventricle of her brain. Doctors initially diagnosed a colloid cyst, a rare, non-cancerous growth.

Six months later, she underwent surgery and was diagnosed with pilocytic astrocytoma, a slow-growing, generally low-grade tumor of the brain or spinal cord.

Also read: Survival In Aggressive Brain Tumors Improves By Up To 50% in India, Say Doctors

Why Brain Tumours Go Undetected In Young Adults

“Brain tumors don’t check your age before making an appearance,” Dr. Turel said. “In young adults, symptoms are often dismissed as stress, migraines, fatigue or lack of sleep. Some tumors grow slowly, allowing the brain to adapt remarkably well.”

“The brain has an extraordinary ability to compensate, especially when a tumor grows slowly or develops in a relatively silent area,” he explained.

Early signs may include persistent headaches, subtle personality changes, difficulty concentrating, blurred vision and unexplained seizures. Other clues include forgetting familiar words, unexplained irritability, occasional imbalance and brief episodes of staring or losing awareness.

Sometimes, family members notice changes before the patient does. Dr. Turel illustrated the difference between ordinary forgetfulness and a potentially concerning change: “If you forget keys, that is OK, but if you forget what the keys are for,” it is a sign to get checked.

“The problem is that these symptoms are common, but their persistence or progression is what deserves attention,” he told HealthandMe.

How Tumor Location Affects Symptoms

Read More: Can 'Eye Strain' Lead To Brain Cancer? Experts Explain

Symptoms often depend more on where a tumor is located than on its size, Dr. Turel explained.

• Frontal lobe: Changes in personality or judgement.
• Temporal lobe: Memory problems or unusual seizures.
• Visual pathways: Blurred or double vision.
• Cerebellum: Problems with balance and coordination.

“New speech difficulties, weakness, unexplained seizures or progressive cognitive changes should never be casually dismissed,” he warned.

Brain Tumor Or Migraine: When Should A Headache Worry You?

Migraines usually follow a recognizable pattern and may involve nausea or sensitivity to light and sound, Dr. Turel said.

Tumor-related headaches are more concerning when they are new, progressively worsening, different from previous headaches or accompanied by neurological changes. They may be worse in the morning or with coughing and straining, although this is not always the case.

A persistent headache that progressively worsens, wakes someone from sleep or occurs with vomiting, visual changes or neurological symptoms warrants medical evaluation.

"A sudden, explosive headache that reaches maximum intensity within seconds—a thunderclap headache—is a medical emergency," the neurosurgeon said, noting that it can occur while "walking, talking and functioning normally"

It may indicate bleeding around the brain from a ruptured aneurysm rather than a tumor. Sudden weakness, confusion, loss of consciousness or a first seizure also require emergency assessment.

“Most headaches are not caused by brain tumors, and a headache alone rarely indicates one. The key is not to panic about every headache, but to recognize when an old familiar headache begins behaving like a stranger,” Dr. Turel said.

When was the last time you stood in a queue without looking at your phone? Or had a cup of tea without scrolling through messages? Or sat in a car, waiting for someone, without opening Instagram simply because there was nothing else to do?

Try it today. Put your phone away for 10 minutes and do absolutely nothing with it. It sounds easy. For many of us, it isn't. The first thing you may notice is not peace, but restlessness. You may wonder if someone has messaged you. You may feel like checking the news, looking at the time or opening an app without even knowing why.

As a neurologist, I find this interesting because it tells us something about how we have trained our attention. Our phones have become so closely woven into everyday life that we often reach for them before we even realize we are bored.

The problem isn't the phone. It's the constant need for stimulation. There is nothing inherently wrong with using a smartphone. We use it to work, communicate, navigate, learn and stay connected.

The problem begins when every small gap in our day has to be filled.

Waiting for the lift? Check the phone.

Waiting for your coffee? Scroll.

Watching television? Check messages.

Feeling slightly bored? Open an app.

Our brains are naturally drawn towards novelty. A notification, a new message or a fresh video gives our attention something new to respond to. When this happens repeatedly, checking the phone can become almost automatic.

That is why I sometimes ask patients not only how much time they spend on their phones, but how often they feel the need to check them. Those are two very different questions.

What Happens When The Screen Goes Away?

The first few minutes may feel surprisingly busy inside your head. An unfinished conversation may come to mind. So might tomorrow's meeting, a pending task or something that has been worrying you. You may also find yourself simply daydreaming.

We often assume that a quiet mind should mean an empty mind. It doesn't. When there is no constant stream of information coming from outside, the mind naturally moves towards memories, plans, emotions and thoughts that have been sitting in the background.

That isn't necessarily overthinking. It is part of normal mental activity. Sometimes we are so quick to distract ourselves that we don't give ourselves the opportunity to notice what we are actually thinking or feeling.

What Should Concern Us Is Fragmented Attention

There is another part of this conversation that gets overlooked. We often talk about screen time, but the way we use our screens matters too. Imagine someone working on an important task but checking WhatsApp every few minutes, responding to an email, looking at a notification and then returning to the original task. Even if the total phone usage doesn't look alarming, their attention has been repeatedly pulled away.

Over time, this can make uninterrupted concentration feel uncomfortable.

So instead of asking only, “How many hours am I on my phone?”, perhaps we should occasionally ask, “How often am I allowing my attention to be interrupted?”

Try The 10-minute Test

You don't need to give up your phone or spend an hour meditating. Start small.

Have your morning tea without a screen. Sit on the balcony. Take a short walk without headphones. Wait for five or 10 minutes without automatically reaching into your pocket.

Don't try to stop your thoughts. Just notice them. You may discover that you are more restless than you expected. Or perhaps you will find that your mind settles after a few minutes.

Either way, that is useful information. Mental wellbeing isn't only about learning how to manage stress when it becomes overwhelming. It is also about creating small pockets of time in which the brain isn't constantly being asked to consume, respond and move on.

In a world that has made every spare minute scrollable, being comfortable with a little silence may be a surprisingly valuable habit for the brain.

(Dr Neha Pandita, Senior Consultant Neurologist and Unit Head, Clinical Lead - Parkinson's disease & Movement Disorders, Fortis Hospital, Noida)