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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Billionaire entrepreneur Bryan Johnson, known for meticulously tracking his health and pursuing longevity, recently revealed that he has been diagnosed with Autoimmune Gastritis, an incurable autoimmune condition in which the body's immune system attacks the stomach lining.
Describing the disease on social media platform X, Johnson said: "My stomach is eating itself." He also noted that despite undergoing extensive medical evaluations over the years, the condition went undetected because autoimmune diseases often develop quietly, with symptoms that can easily be mistaken for everyday health issues such as fatigue or digestive discomfort.
According to the Centers for Disease Control and Prevention (CDC), autoimmune diseases occur when the immune system mistakenly attacks the body's own healthy cells and tissues, triggering inflammation and damage to organs or other body systems.
The burden of these conditions is significant. In May 2025, researchers from the Mayo Clinic and collaborating institutions estimated that nearly 15 million Americans are living with one or more of 105 recognized autoimmune diseases.
Because autoimmune diseases often begin with vague, non-specific symptoms, they can remain undiagnosed for months—or even years.
Dr. Cory Rice, a US-based Functional Medicine physician, said these warning signs frequently go unnoticed until the disease has progressed.
"First and foremost, symptoms of autoimmune disease can come and go, and be on and off, or they can be more persistent in nature," he told Newsweek.
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While symptoms vary depending on the various autoimmune conditions, several early warning signs are shared across many autoimmune diseases.
According to Dr. Rice, common symptoms include:
He said when people suffer from fatigue, "it is usually both profound and debilitating."
Dr. Rice explained that many people try to manage this overwhelming exhaustion by relying on caffeine and other stimulants, taking thyroid medications or hormone treatments, or opting for therapies such as intravenous infusions and vitamin B12 injections.
However, when an underlying autoimmune disease is responsible, these approaches often fail to provide lasting relief.
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One of the biggest challenges in diagnosing autoimmune diseases is that their symptoms overlap with those of many other medical conditions.
Johnson also said that "2-5 per cent of people have this (autoimmune disease). Likely more, because it hides".
Symptoms may also appear intermittently before becoming more persistent.
"It all depends on the disease process in play and the severity or progression of the disease itself in a particular person as to whether symptoms are more constant or intermittent," Rice said.
He added that many primary care physicians are not routinely trained to identify autoimmune diseases in their early stages. As a result, patients are frequently referred to specialists, including rheumatologists, only after symptoms have become more pronounced.
"Unfortunately, by this point, the autoimmune disease may already be far along in whichever parts of the body are impacted," he said.
Dr. Rice emphasized that recognizing symptoms early and obtaining a timely diagnosis can help slow disease progression and improve long-term outcomes.
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The United States is currently experiencing one of its worst Cyclospora outbreaks in recent years, with health officials still unable to determine the source of the infections.
According to the latest data, the outbreak has spread across at least 18 states. Michigan has reported at least 1000 cases, emerging as the hardest-hit state. With around 40 hospitalisations, no deaths have been reported so far.
The outbreak is being investigated by the U.S. Centers for Disease Control and Prevention (CDC), the U.S. Food and Drug Administration (FDA), and state health departments. Investigators have not yet identified a single contaminated food source.
Several other states have also reported rising case counts. New York City has confirmed hundreds of infections since May. Health officials believe the actual number of infections is likely higher because Cyclospora is not routinely tested for in people with diarrhea. Symptoms usually begin about one week after exposure and can last weeks if untreated.
A Cyclospora infection can be mild or severe and may last for weeks or even months. It is typically treated with antibiotics. People with weakened immune systems, such as those with HIV/AIDS or cancer, are at greater risk of severe disease.
Cyclospora infection commonly causes:
Health authorities in the US continue to advise people to wash fresh produce thoroughly, maintain good hand hygiene, and seek medical care if they develop prolonged watery diarrhea, especially if symptoms persist for several days.
While there is no indication of a similar outbreak in India, infectious disease experts say the country's monsoon season creates conditions that can facilitate the spread of intestinal parasites if food and drinking water become contaminated.
HealthandMe spoke to Dr. Devashish Desai, Consultant, Infectious Diseases at Ruby Hall Clinic, if India, too, faces a possibility of a parasitic infection like cyclospora, especially in monsoon season.
Dr Desai said, “The answer is yes. India's monsoon creates conditions that favour the spread of several water and food-borne infections, including Cyclospora. Heavy rainfall can contaminate drinking water sources and fresh fruits and vegetables with sewage or infected soil. Consuming raw salads, unwashed herbs, or untreated water significantly increases the risk of infection.”
Unlike bacteria, cyclospora parasites require time in the environment before they become infectious, meaning direct person-to-person transmission is uncommon. Instead, contaminated food and water remain the primary sources of infection. This makes maintaining hygiene from farms to kitchens essential for prevention.
The expert added, “Although Cyclospora outbreaks are not commonly reported in India, the environmental conditions during the rainy season make vigilance essential. Strong food safety practices, clean water, and good personal hygiene remain the most effective defences against this preventable parasitic infection.”
Although India has not reported a similar outbreak, experts say the current situation in the US is a stark reminder that food safety and sanitation become even more critical during the monsoon.
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For millions of people living with diabetes, the condition is not managed in moments; it is managed in the countless choices made between moments. From planning meals and staying active to monitoring glucose levels and following treatment schedules, people living with diabetes make countless decisions every day that shape their long-term health.
In clinical practice, we often see that the success of treatment is determined not only by how effective a therapy is, but also by whether it can be realistically sustained over years and decades. This is why the future of diabetes care must move beyond advancing therapies alone and focus on developing treatment approaches that are simpler, more flexible, and designed around patients' lives.
Despite being one of the most widely recognized health conditions today, diabetes is still often misunderstood as simply a condition of “high sugar levels”. In reality, it is a metabolic disorder that develops when the body either does not produce enough insulin or is unable to use insulin effectively.
While genetic factors play an important role, rapid urbanization, sedentary lifestyles, changing dietary patterns, and rising obesity have contributed significantly to its increasing prevalence. Today, nearly 101 million adults in India are living with diabetes, according to the ICMR-INDIAB study.
With diabetes, time itself becomes a critical risk factor; the longer a person lives with the condition, the more severely it affects multiple organ systems. Diabetes can affect the heart, kidneys and nerves, with complications developing silently over several years. While improvements in the management of key cardiometabolic risk factors such as blood pressure, lipids and glycaemia have helped improve outcomes in several areas, lifestyle-related factors continue to contribute to long-term risks. This highlights the need for early risk identification, timely intervention and continuous monitoring to reduce the long-term burden of disease.
The progressive nature of diabetes also means that care is not limited to clinic visits; it extends into everyday life. It requires individuals to make repeated decisions throughout the day, and this constant cognitive load can become overwhelming, often leading to treatment fatigue and difficulty in maintaining consistent control.
Thus, treatment adherence is one of the strongest determinants of diabetes control. Yet real-world adherence is shaped by multiple overlapping factors. Limited understanding of the disease and its often-silent progression, along with psychological challenges such as anxiety or depression, can affect a person’s ability to remain consistent with treatment.
At the same time, complex treatment regimens, polypharmacy and the long-term burden of managing a chronic condition can make adherence more challenging. Financial constraints, limited access to medicines, and gaps in regular follow-up and patient–provider communication further add to the difficulties of sustained diabetes management.
Together, these factors contribute to poorer glycemic control, higher complication rates, increased hospitalizations and reduced quality of life.
Recognizing the realities of living with diabetes, care has increasingly shifted towards approaches that balance clinical effectiveness with practicality in everyday life, with greater emphasis on long-term sustainability and individual patient needs. Supporting this shift is a new generation of innovations in diabetes care that is making it more personalized, flexible and easier to manage, including:
Continuous Glucose Monitoring (CGM) has helped shift focus from HbA1c alone to include dynamic measures such as Time in Range (TIR) and glucose variability, enabling more real-time, personalized adjustments.
Oral therapies such as DPP-4 inhibitors (gliptins) and SGLT2 inhibitors (gliflozins) have expanded treatment options by helping improve glucose control while supporting more personalized and holistic diabetes management.
Newer ultra-long-acting basal insulins and ultra-rapid-acting mealtime insulins have improved glycemic stability.
More recently, innovative solutions like once-weekly insulin icodec have been available globally that offer a simplified regimen, reduced treatment burden and improved patient adherence. This weekly insulin is now approved and launched in India for adults living with diabetes. This novel therapy could potentially reduce the practical burden of treatment and make long-term management more achievable in real-world settings.
Ultimately, the future of diabetes care will not be defined by how strictly patients follow treatment schedules, but by how well treatment fits into their lives. When care is designed around patients rather than systems, adherence becomes more natural, outcomes improve more sustainably, and diabetes management becomes less about daily struggle and more about improving the quality of life for those with diabetes.
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