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HIV and COVID-19: Risks, Concerns, and the Best Way to Protect Yourself

  • Currently, there’s no scientific evidence that establishes living with HIV as an increased risk factor for COVID-19.
  • Some HIV medications are being used in clinical trials to see whether they can combat SARS-CoV-2, the virus that causes COVID-19.
  • So far, not enough information is known about how effective these drugs could be as COVID-19 treatments.

Like most people right now, New York City–based actor and HIV advocate Dimitri Joseph Moïse has been confined to his apartment for the past month as he self-quarantines during the COVID-19 outbreak.

Moïse, who’s been on TV in “The Last O.G.” and on Broadway in “The Book of Mormon,” has amassed a large social media following for his HIV activism, often fielding questions from other people living with HIV.

He says he’s been hearing more frequently about concerns tied to the COVID-19 outbreak.

“I would say some people are definitely worried about whether they are at a greater risk [for COVID-19] because they’re living with HIV,” Moïse told Healthline.

Currently, there’s no scientific evidence that establishes living with HIV as an increased risk factor for COVID-19, according to the Centers for Disease Control and Prevention (CDC).

That being said, as confirmed cases of COVID-19 continue to increase steeply nationwide, concern is high among members of the community of people living with HIV.

What we know right now about COVID-19 and HIV

While there’s no science that establishes HIV itself as an increased risk factor for COVID-19, it doesn’t mean that people living with HIV should have no concerns.

The CDC reports that roughly half of people in the United States living with HIV are at least 50 or older.

Generally, they also have a higher risk for contracting severe illness and have higher rates of comorbidities, like smoking, high blood pressure, and COPD, which all could lead to a higher susceptibility to COVID-19’s more serious symptoms.

“Adhering to your medical regimen and keeping firm control of your HIV remains critically important to the health of HIV patients,” Dr. Alan Taege, an infectious disease expert at Cleveland Clinic, told Healthline.

“For those who have underlying diabetes, heart disease, or lung disease, or any other significant medical illness, it would appear they are at increased risk,” he said.

Dr. Hyman Scott, MPH, the clinical research medical director at Bridge HIV and an assistant clinical professor of medicine at the University of California, San Francisco (UCSF), told Healthline that while there’s no hard data showing how at-risk people aren’t adhering to — or don’t have easy access to — HIV medications right now due to COVID-19, logic holds that this group should be vigilant about their health.

“Individuals who are immunosuppressed, whose T cell counts are low and are off medication for whatever reason, do have more concerns for having more severe diseases in general and more complications,” he explained.

Additionally, many people living with HIV are also part of other communities that are acutely susceptible to being hit hard by an epidemic like COVID-19.

People of color, those who have lower incomes, sex workers, members of the transgender community: All are societally vulnerable groups that don’t always have access to the resources or support to best protect their health.

Dr. David Goodman-Meza, MAS, an assistant professor in the division of infectious diseases at University of California, Los Angeles (UCLA), says that one group with known risk factors HIV that’s sometimes overlooked in these discussions are people who use injectable drugs.

He adds that the federal government has recently relaxed a lot of previous constraints that were in place to provide therapies to these groups.

For instance, people using methadone are being given access to take-home treatments so they don’t have to visit physical clinics during the pandemic.

Taege says he would urge anyone living with HIV and not on treatment to “get in touch with their local care providers” right now to see whether there’s a way they could be placed on therapy.

“We can find assistance for almost everyone today,” he stressed.

If a person maintains their HIV medication regimen, they can achieve an “undetectable” viral load, which means a person can’t transmit the virus to HIV-negative sexual partners, according to the CDC.

Goodman-Meza says the data currently available out of China where COVID-19 was first reported in late 2019 hasn’t seemed to show any stark differences in how the disease is affecting people who are living with HIV versus those who aren’t.

“I can tell you, anecdotally, that at UCLA we have yet to have a hospitalized patient infected with COVID who has been living with HIV,” he said.

Lately, some news has circulated that HIV medications are being used in clinical trials to see whether they can combat the virus that causes COVID-19.

So far, not enough information is known about how effective these drugs could be as COVID-19 treatments.

Getting accurate information out there

To quell fears, Moïse has been using his role as an influencer to dispel some myths and misconceptions about both HIV and COVID-19.

On Instagram, he recently shared a video conversation with fellow HIV activist and actor Hernando Umana that lays out helpful facts about HIV and the current pandemic.

He also reposted a public awareness campaign about HIV treatments that he previously worked on with the CDC.

In a current age when misinformation proliferates widely, Scott of UCSF adds it’s crucial people with a platform share accurate facts about both conditions on social media.

He says, like the larger population, people living with HIV need to practice proper COVID-19 prevention methods: physical distancing and sheltering in place, regular handwashing, and committing to only leave the home for essential travel, like grocery shopping or pharmacy visits.

Additionally, the CDC recommends that people living with HIV eat a healthy diet, try to get at least 8 hours of sleep, and try their best to reduce their stress levels as much as possible.

Another key is access to medication. The CDC recommends people living with HIV have at least a 30-day supply of their antiretroviral medications.

“People should be aware that we are in ‘crisis mode,’ and they should have a ‘survival kit’ to make sure they have access to a supply of medication of at least 30 days that they request from their doctors. I’d go so far as to push that to 90 days,” Goodman-Meza said.

“A lot of the insurance companies are relaxing limits on the number of pills that can be prescribed at a time to accommodate longer prescription requests,” he added.

COVID-19, HIV, and mental health

Another big issue for people living with HIV right now is dealing with mental health concerns.

While it’s an official CDC recommendation for people living with HIV in the midst of an epidemic, “reducing stress” is sometimes easier said than done.

“Anxiety and fear are a normal part of uncertain and unfortunate circumstances that we are living through today. I would urge people to seek out their HIV care providers as well as their social workers for counseling information and support,” Taege said.

Taege adds that people should look for local healthcare resources in their communities if they think they need a higher level of psychological care and support.

Goodman-Meza says mental health issues affect a large proportion of the community of people living with HIV.

He says that at the start of this new epidemic, he received calls from patients tied to their anxieties about everything from whether they should go into the workplace, visit their gym, or even leave the house for groceries at the nearby supermarket.

“There were a lot of questions of, ‘What is my risk?’ and I would try to counsel them about what we know based on the data,” Goodman-Meza said. “My advice is to try to be as careful as you can.”

He adds that now as anxieties run high around COVID-19, people living with HIV should keep in contact with their regular HIV providers.

“Most docs who are HIV providers love to help their patients and are very willing to provide resources and try to help people through whatever issue they have. So, my number one is to call your HIV doc, number two, go to your local HIV organizations. Could be support groups, LGBTQ organizations, clinics,” he said.

Goodman-Meza, Taege, and Scott all add they’re practicing telemedicine at this time to try to make their services as accessible as possible to people who now find themselves confined to their homes.

“At my clinic, we are also advocating for an increase in home-based testing for people at risk for HIV, follow-ups through telemedicine, doing everything to ensure our services are accessible,” Goodman-Meza stressed.

Connecting with community

Moïse has been a vocal advocate for nearly 2 years — about as long as he has been living with HIV.

He says he’s been struck by some of the messages he receives from people whose memories and past trauma from the height of the AIDS epidemic of the 1980s and ’90s have been triggered by our current global public health crisis.

“A lot of people are going through an additional trauma on top of this collective trauma we are dealing with. A few people I’ve been talking to say this epidemic is reminding them of the AIDS epidemic, of their diagnosis from the ’80s or the ’90s, or whenever it was,” Moïse said.

He adds that people are finding troubling parallels to the past, worried that they are “living under an administration that cares more about how the economy is affecting the country rather than the public health crisis itself.”

“You have a community that is marginalized by the government and stigmatized already, and now you add an additional scare of access to their medication, of getting their testing done, of whether they will fall even further on the totem pole of priority,” Moïse explained.

“A lot of people have trouble trying to refill their prescriptions, of not being on insurance, or getting kicked off their insurance if people are losing their jobs,” he said.

Moïse says he’s fortunate to have access to the care, HIV medications, and support he needs, but adds that, as with everyone, he can get overwhelmed by the current health crisis.

He says he’s a huge proponent of seeking professional therapy, which for many now is just a video or phone call away.

This could be exceptionally helpful for people living with HIV who are now dealing with multiple stressors at once as the pandemic continues to sweep through the country and the world.

Moïse also advises that connecting with one’s personal community can offer a brief escape from COVID-19 concerns.

“Even if it’s a quick chat with a friend, just to brighten the day and talk about RuPaul or ‘Tiger King’ or whatever to get your mind off of it all,” Moïse said. “The world has basically shut down. Give yourself some time to rest or connect with someone you care about.”

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  • Posted on April 15, 2020