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.
Going for timely fertility evaluations is a good way to dodge the risk of pregnancy complications. (Photo credit: AI generated)
Changing lifestyles, career priorities, financial planning, and personal choices are leading many couples to marry later than before. While late marriages are becoming increasingly common, fertility specialists are observing a parallel rise in delayed pregnancy planning and age-related fertility complications. Many couples now begin trying to conceive only after the age of 35, when fertility in both men and women naturally starts declining.
Currently, there is a growing trend of late marriages due to career priorities, financial stability goals, higher education, and changing lifestyle choices. Many couples are choosing to settle professionally and personally before planning a family. However, this delay can also lead to postponed pregnancy planning, often at a stage when fertility naturally starts declining. Increasing stress, underlying medical conditions, and lack of fertility awareness are further contributing to challenges in conception among couples in their mid to late thirties.
“The increasing trend of late marriages (30–35+) is directly leading to delayed pregnancy planning. Most couples start trying to conceive after 35, when fertility has already begun to decline significantly. By the time many patients seek medical help between 36 and 39 years, several are diagnosed with low ovarian reserve (low AMH) or conditions such as oligoasthenoteratozoospermia (OAT) and azoospermia.
Lack of early fertility awareness often causes women to miss the window for timely intervention or fertility preservation options like egg freezing. Advanced maternal age pregnancies (40+) are steadily rising and are often associated with complex complications and lower treatment success rates. Currently, nearly 75% of fertility patients are above 35 years of age, while 25% are above 40. Only around 20% of patients are in their late 20s,” said Dr. Jyotshana Palgamkar, Fertility Specialist, Nova IVF Fertility, Virar.
Dr Jyotshna further added, “One of the biggest concerns linked to late pregnancy planning is reduced ovarian reserve in women. By the time many women seek medical help between the ages of 36 and 39, their anti-Müllerian hormone (AMH) levels, which indicate egg reserve, may already be low. This reduces the chances of natural conception and can also affect the success rates of fertility treatments. Male fertility is also being affected. A large number of men are diagnosed with oligoasthenoteratozoospermia (OAT), a condition in which sperm count, motility, and morphology are affected.
Delayed fertility evaluation often means that couples lose valuable time before beginning treatment or considering assisted reproductive options. Another major challenge is the lack of awareness about fertility preservation. Many women remain unaware that egg freezing at a younger age may help preserve fertility for the future. By the time they start exploring fertility options in their late thirties or forties, treatment becomes more complex and emotionally stressful. Advanced maternal age pregnancies, especially above 40, are also increasing. These pregnancies are often associated with lower conception rates, higher miscarriage risk, pregnancy complications, and reduced IVF success rates,” Dr Jyotshna explained.
Male fertility treatment options depend on the underlying cause of infertility and may include lifestyle changes, medications, hormonal therapy, or surgical procedures. “Conditions such as low sperm count, poor sperm motility, abnormal morphology, raised DNA fragmentation index (DFI) affecting sperm quality, varicocele, or azoospermia can often be managed with timely medical intervention. Assisted reproductive techniques like IUI, IVF, and ICSI are also commonly used to improve the chances of conception. Early diagnosis and proper fertility evaluation play an important role in selecting the most effective treatment option for men,” said Dr Palgamkar.
Understanding fertility timelines, seeking timely evaluation, and discussing preservation options early can help couples make informed decisions and improve their chances of successful parenthood in the future.
Lack of exercise can contribute to back pain. (Photo credit: AI generated)
Back pain is generally considered a problem seen in old age, but of late, we are increasingly seeing younger adults suffering from back pain. Prolonged sitting hours, inadequate physical activity, smoking, and an unhealthy lifestyle have made back pain a common complaint even in people under 30 years of age.
In an interview with Health and Me, Dr Pramod Sudarshan, Spine Surgeon (ortho), Apollo Hospitals, Bangalore, said, “Most commonly, we attribute this pain to a slipped disc or other disc-related conditions. However, they are just one among many reasons causing back pain. A thorough understanding of the other conditions that can lead to back pain, and knowing the ‘red flags’ to help identify them, will assist in seeking early treatment and preventing further complications.”
Muscle strain is considered to be one of the most common reasons for developing back pain in younger individuals. Daily activities like travelling for long hours, lifting heavy weights without proper technique, and carrying heavy backpacks can lead to muscle strain. Often, the pain due to muscle strain comes down with the help of medications such as muscle relaxants and rest.
Working professionals and students spend many hours a day studying, gaming, and working on computers without maintaining proper posture, leading to excess strain on the back muscles and, in turn, prolonged back pain. Having a properly ergonomically designed workstation/study table setup can prevent back discomfort and stiffness.
Lack of physical activity and associated conditions such as obesity weaken our core muscles, which are considered the main pillars supporting our spine. Weakened core muscles will not be able to perform the functions expected of them, leading to back pain. Regular exercise, weight management, a healthy diet, and guided weight training will help strengthen our core muscles and reduce the risk of back pain.
Other than muscles, the spine also contains small joints known as facet joints, irritation or inflammation of which can lead to back pain. A structure known as the pars interarticularis acts as a clamp in the spine, holding two adjacent vertebral bodies, and any defect, such as a congenital defect or fracture due to repetitive microtrauma, as seen in gymnasts, can lead to the slipping of one bone over the other, causing back pain.
Though mechanical back pain is most common, there are other conditions such as inflammatory arthropathy, tumours, and infections. Conditions such as ankylosing spondylitis, rheumatoid arthritis, and hyperuricemia/gout are some examples of inflammatory conditions in which an individual experiences early morning back pain associated with stiffness and may also present with pain in other joints.
Tuberculosis affecting the spine is considered the most common infection of the spine. Severe back pain, weight loss, loss of appetite, fever, and night sweats are some of the common symptoms. Other bacterial and fungal infections are also seen affecting the spine, most commonly in immunocompromised individuals.
Tumours, though rare in young individuals, warrant further investigation when symptoms such as severe weight loss, night pain, and prolonged back pain are present to rule out the possibility of tumours.
Other conditions such as scoliosis (congenital/adolescent idiopathic scoliosis), which is a three-dimensional deformity of the spine, can cause back pain. It requires further assessment in the form of radiological investigations to assess the degree of deformity and to plan any surgical intervention, if required, based on the severity of the curve.
Identifying some of the red-flag signs, such as weakness in the legs, numbness around the groin, bladder or bowel dysfunction, fever, unexplained significant weight loss, or severe pain following major trauma, is essential. These symptoms may indicate serious underlying pathology requiring medical care.
Fortunately, back pain in young people is largely preventable. Basic lifestyle modifications such as regular exercise, maintaining proper posture, avoiding prolonged sitting, maintaining a healthy body weight, undertaking monitored weight-training programmes, following a healthy diet, and getting adequate sleep will help prevent as well as overcome existing back problems. Invest in your spinal health at the earliest opportunity to reap the benefits in the second half of life.
Credits: Canva
Researchers from the University of Oxford and pharmaceutical firm Moderna have developed a vaccine that may prevent bowel and ovarian cancer. The first trial is to be this summer, and it will try to see if the vaccine can train the immune system to recognize and eliminate pre-cancerous cells in people with Lynch syndrome before cancer develops.
In the United Kingdom, one in 300 people has Lynch syndrome, an inherited health condition that massively increases the chance of contracting cancers like bowel and ovarian cancer.
Colorectal cancer is the umbrella term for both colon and rectal cancer. As the name also suggests, colon cancers happen only in the colon, but if it is left untreated, it can spread to different organs in your body. Colorectal cancer begins inside the rectal tissues or the colon walls. It presents itself in the earliest stages as small masses, known as polyps. If a polyp becomes cancerous, it can spread cancer from the inner part of the colon to the lymph nodes or bloodstream. If this happens, cancer can then quickly move throughout the system.
Ovarian cancer is one of the deadliest gynecological cancers and is often referred to as the “silent killer” because its early symptoms are vague and easily mistaken for common digestive or urinary issues.
It develops when abnormal cells in the ovaries grow uncontrollably and may spread to other parts of the body. Survival rates are significantly higher when detected early—around 93 per cent of women diagnosed at stage one survive at least five years, compared to just 13 per cent at stage four, according to the American Cancer Society.
Unfortunately, many cases are diagnosed at advanced stages, when treatment options are limited, and outcomes are poorer.
“Ovarian cancer is commonly called a ‘silent disease’ because its early signs are vague and often resemble routine gastric issues,” Dr. Tejinder Kataria, Chairperson – Radiation Oncology, Medanta Hospital, Gurugram, told HealthandMe.
Common symptoms include:
Dr. Parminder Kaur, Consultant Gynaecologic Oncologist at CK Birla Hospital, Delhi, told HealthandMe that the key concern is when symptoms become frequent, persistent, and unusual for an individual’s normal health pattern.
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