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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Per- and polyfluoroalkyl substances (PFAS), commonly known as forever chemicals, have sparked interests of epidemiologists who are investigating their links to chronic diseases like high blood pressure, cardiovascular conditions and certain cancers.
PFAS are a large group of chemicals made by humans that have been used in industrial processes and everyday consumer products. They are found in cosmetics, kitchen supplies, clothing, carpets, upholstery, food packaging and other household materials.
They are called forever chemicals because their strong chemical bonds make them resistant to breaking down in the environment. Some PFAS can also exist in the human body, allowing exposure to accumulate over time.
At the American Public Health Association's (APHA) 2026 Annual Meeting, researchers presented findings on how people are exposed to these chemicals everyday through food and drinking water, and what long-term health consequences may be related to that exposure.
Some studies have identified that PFAS exposure could lead to colon and liver cancers, low birth weight, development problems in children, complications during pregnancy and other metabolic disorders. Research has also identified its exposure to cholesterol, changes in liver enzymes, reduced antibody responses to some vaccines and hypertension during pregnancy.
However, this does not establish that PFAS exposure directly causes every condition reported in epidemiological studies. Health effects may depend on the chemical type, exposure levels, duration of exposure and individual factors.
The US Agency for Toxic Substances and Disease Registry (ATSDR) states that research into PFAS health effects is in progress.
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Besides drinking water, food can also contribute to exposure, prompting researchers to investigate whether dietary habits influence the relationship between PFAS and chronic health conditions.
One study conducted in Massachusetts examined the relationship between dietary patterns, PFAS exposure and blood pressure. Researchers found stronger associations between a specific PFAS compound and high blood pressure among people who regularly consumed fish.
Yuting Wang, a postdoctoral research fellow at Silent Spring Institute and one of the researchers involved in the study, said animal-based foods appeared to contain more PFAS than plant-based foods.
One possible explanation, she suggested, was that meat consumption could increase inflammation, which may influence the relationship between PFAS exposure and blood pressure.
"Better understanding interactions among diet, PFAS and blood pressure may improve clinical recommendations to prevent hypertension," Wang said. "Future studies should account for exposure to environmental pollutants in addition to nutrient benefits of certain food," she added.
According to the US Geological Survey, approximately 45% of drinking water samples collected across the country showed traces of PFAS. Researchers have also investigated PFAS contamination in 11 townships in southeastern Pennsylvania. Their testing found that several drinking water supplies had PFAS concentrations exceeding the US Environmental Protection Agency's 2021 regulatory limits.
The team also examined two decades of mortality data from the townships to investigate whether areas with higher PFAS levels in public drinking water has different patterns of disease and death.
Erin Kulick, an assistant professor of epidemiology and biostatistics at Temple University College of Public Health who worked on the Pennsylvania study, said, "Southeastern Pennsylvania experiences overlapping burdens of PFAS exposure and cardiovascular disease."
PFAS contamination is a public health concern because these chemicals can remain in the environment for long periods and reach people. Some PFAS accumulate in the body, and repeated exposure may increase the amount present over time.
The National Institutes of Health identifies several health concerns linked with exposure to certain PFAS, including immune system effects, increased cholesterol, liver changes, pregnancy-related complications and some cancers.
The US Environmental Protection Agency has established legally enforceable drinking water limits for six PFAS compounds, including perfluorooctanoic acid (PFOA) and perfluorooctanesulfonic acid (PFOS).
Researchers say more comprehensive monitoring, better assessment and long-term epidemiological studies are needed to understand how PFAS contamination affects communities.
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A simple five-factor risk score may help identify people at high risk of dementia, particularly in low- and middle-income countries (LMICs), where around 60% of the world's dementia cases now occur.
Developed and validated by researchers at Northumbria University, the risk score uses five everyday factors to identify older adults at higher risk of dementia. It aims to address a gap in dementia research, as existing prediction tools have largely been developed using data from high-income countries and may not work as well in lower-income settings.
The research team developed the model using data from more than 11,000 older adults across seven countries and three continents.
“We know the burden of dementia is shifting towards lower-income parts of the world, yet the prediction models clinicians and researchers rely on were designed with wealthier populations in mind. This model is a step towards changing that. It is simple, it is built for the settings where it is needed most, and it gives researchers a practical way to find the people who should be the focus of future studies and trials,” said Dr Eduwin Pakpahan, from Northumbria University's Applied Statistics and Data Science Research Group. The study is published in the American Journal of Epidemiology.
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The model can be applied using information gathered through a straightforward conversation with an older adult and, where relevant, a family member or carer. It does not require blood tests, brain scans or specialist equipment.
The five factors included in the risk score are:
Each factor contributes points towards a total score ranging from 0 to 9. A person scoring 0 has around a 1% chance of developing dementia within three years, while someone scoring 9 has a nearly 19% chance.
The researchers built and tested the model across seven sites in China, Cuba, the Dominican Republic, Puerto Rico, Venezuela, Mexico and Peru. It achieved a performance score of 0.75, above the 0.70 threshold generally regarded as clinically useful.
However, the researchers emphasise that the tool is primarily intended for research rather than routine screening of the general population. It could give researchers and clinical trial teams a practical, low-cost way to identify and recruit people at higher risk of dementia.
The team has also called for the model to be validated in regions not covered by the study, particularly South Asia, the Middle East and North Africa, and Sub-Saharan Africa.
Read More: Dementia Is More Than Forgotten Birthdays, Lost Keys: Doctors Explain Early Signs Before Memory Loss
Dementia affects more than 57 million people worldwide, with around 60% of cases occurring in LMICs across Latin America, the Caribbean, Asia and Africa.
Identifying people at higher risk could help researchers in these regions plan studies and clinical trials that better reflect their populations. A simple tool based on everyday information may also make risk assessment more accessible in settings where specialised diagnostic resources are limited.
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From Independence Day and Janmashtami to Ganesh Chaturthi, Onam, Eid, Navratri, Dussehra, Diwali, Christmas and New Year, the period from August to January means celebrations across the country. However, some can also suffer from stress, loneliness and worsening of pre-existing mental health symptoms.
In India, festivals can provide connection, cultural continuity and family bonding. However, celebration is not positive for everyone. For some, the period can lead to issues such as social pressure, loneliness, grief, financial concerns and even interpersonal conflict. Festive periods can be challenging for the general population, while people with pre-existing mental health conditions may be vulnerable to worsening symptoms, increased sensitivities or relapse.
Festivals carry an expectation that everyone should be happy. People are expected to participate, dress up, attend gatherings and appear enthusiastic. Though some may experience anxiety, burnout, depression or emotional exhaustion, maintaining this expected level of participation can become another source of stress. Emotional wellbeing does not automatically change because it is a festival. Recognising this can reduce guilt and self-criticism.
Festivals frequently bring extended families together. While this can strengthen relationships, it can also reactivate longstanding interpersonal dynamics. Questions about marriage, children, career, finances, appearance or personal choices can become uncomfortable, particularly when they touch existing vulnerabilities.
For someone who has experienced criticism or comparison within the family, a seemingly casual festive comment may carry considerably more emotional weight because of the history attached to it. The festive setting can therefore bring individuals into closer contact with relationships or unresolved issues that they may otherwise have greater distance from.
For individuals already living with a mental health condition, the festive season can introduce several stressors simultaneously. Travel, disrupted sleep, irregular meals, increased social stimulation, financial pressure, family conflict and interruptions to established treatment routines can place additional demands on psychological functioning.
People with conditions such as depression, anxiety disorders, bipolar disorder, trauma-related conditions, obsessive-compulsive symptoms, eating disorders or other psychiatric difficulties may be more sensitive to these changes.
In individuals with a history of recurrent episodes, significant disruption may also contribute to relapse. Festivals themselves do not necessarily cause relapse. Rather, the accumulation of environmental, interpersonal and behavioural stressors can increase vulnerability in someone already at risk.
Changes from an individual's usual baseline such as significant alterations in sleep, appetite, mood, anxiety, irritability, impulsivity, social withdrawal or functioning can therefore be important early warning signs.
Many traditions are built around shared experiences: preparing food, decorating homes, travelling to family members, exchanging gifts or gathering for meals. When someone important is no longer present, familiar rituals can make their absence more noticeable.
This can occur during religious festivals as well as occasions such as Independence Day or New Year, when people naturally reflect on their lives and relationships. Participating in a celebration does not mean grief has disappeared, just as sadness during a celebration does not eliminate the capacity for joy.
The festive season can also place pressure on household finances. Clothing, gifts, travel, home decoration and social events can increase expenditure over several months. For those already experiencing financial uncertainty, this can create considerable stress.
People living alone, those estranged from family, individuals experiencing relationship difficulties, older adults and people who have recently relocated may become more conscious of social isolation during this period. New Year can be particularly challenging because social expectations around parties, relationships and celebration become highly visible.
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Celebrating Diwali, Eid, Navratri, Onam, Christmas or Gurpurab away from India can provide an important connection with cultural identity and family traditions. At the same time, it can highlight physical distance from parents, siblings and extended family.
A person may attend a community celebration abroad while still missing the food, sounds, neighbourhood atmosphere and family rituals associated with celebrations in India. Those unable to travel home may experience increased homesickness, particularly when several major occasions occur within a short period.
Feeling tired, overwhelmed, irritated, lonely or emotionally sensitive during a demanding period does not automatically indicate a psychiatric disorder.
Even psychologically healthy individuals can experience festive stress because of travel, social obligations, financial commitments or difficult family interactions.
For those receiving mental health care, prescribed medication, therapy and established support systems should not be casually disrupted during the festive period.
Curated festive content represents selected moments, not the entirety of another person's life.
Professional support becomes particularly important when festive stress is accompanied by persistent hopelessness, severe anxiety, substantial social withdrawal, changes in sleep or appetite, increased substance use, impaired functioning or other marked behavioural changes.
The goal is not to remove complexity from celebration, but to make space for it. Allowing people to experience the festive season without the pressure to feel festive can itself be an important form of psychological care.
By Ms Dhara Ghuntla, Psychologist/Psychotherapist, Sujay Hospital, 7 Hills Hospital & Criticare Hospital
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