COVID-19 and People Living with HIV
Frequently Asked Questions
W. David Hardy, MD
Hello FAM Supporters:
This column, focusing on the medical aspects of AIDS & HIV, will be a regular feature of the FAM newsletter written by me or one of my medical colleagues. I hope that you will enjoy reading this inaugural column on the interaction between HIV and COVID-19.
Disclaimer: This document is not intended to provide medical advice.
Please contact your health care provider or clinic for medical advice and guidance.
COVID-19 & HIV Questions & Answers
Are people with HIV at higher risk for catching or becoming ill from COVID-19?
Although not entirely conclusive, most of the information available on COVID-19 and people with HIV confirms that people with HIV who are taking antiretroviral medication and have suppressed viral loads are neither more susceptible nor at higher risk for becoming ill or dying due to COVID-19 than HIV-negative people.
However, it is important to note that people with HIV who are older (> 50-years-old) and/or who have poorly controlled HIV, as well as other conditions like heart, lung or kidney disease, or diabetes, should be cautious.
To learn more, check out the CDC’s COVID-19: What People with HIV Should Know .
Should I see my HIV doctor or medical provider during the outbreak?
Many healthcare providers, including HIV doctors and clinics, are having telephone, telehealth or video visits with their patients so they do not have to come into the clinic. If you are not feeling well and need to see your healthcare provider in person, for your own protection, call before going to the clinic.
Should I still get my regular lab work done?
Contact your healthcare provider if you are due for lab work. If your viral load has been well-suppressed (undetectable) and you are not having any health issues, your healthcare provider may delay your routine medical monitoring for up to six to nine months. See COVID-19 Considerations for People with HIV for more information.
Do my HIV medications protect me from catching COVID-19?
There is no information that demonstrates that HIV medications can prevent or treat COVID-19. In fact, studies of two protease inhibitors, Kaletra® and Prezista®, have shown that they do not have any treatment benefit for people with COVID-19. Similarly, studies of Truvada® (which is in the same class of drugs as Remdesivir, an FDA-approved treatment for COVID-19) have not shown conclusive evidence of preventing or treating COVID-19. Read more in the CDC’s What to Know About HIV and COVID-19.
More information on HIV treatment recommendations and COVID-19 is available in the HHS Interim Guidance on COVID-19 and Persons with HIV.
I’m HIV-positive. What if I need to be hospitalized and require critical care because of COVID-19?
If you experience severe COVID-19 symptoms and need to be hospitalized, it is important that your hospital medical team be aware of your HIV status, your medical history regarding HIV, and the HIV medications you are taking. Continuing your HIV care in the hospital will be essential to your COVID-19 recovery.
Initially, there was some concern that people living with HIV may not receive the same COVID-19 care as those in the general population, notably that they may be denied access to a ventilator if a hospital needs to ration critical care. Fortunately, however, there has been no evidence of this nor cases that demonstrate such. The HIV Medicine Association (HIVMA) updated their COVID-19: Special Considerations for People Living with HIV stressing that people living with HIV have a normal life expectancy and:
- HIV status should not be a factor in medical decision-making regarding life-saving intervention decisions (for example, ventilator use) or enrollment into clinical trials; and
- Care and treatment for COVID-19 in people living with HIV should follow the same protocols advised for patients without HIV.
People with HIV who have COVID-19 should receive the same medical care as anyone with COVID-19.
What can I do if I think I may have trouble getting the right care because of my HIV status?
I think I may be HIV-positive, and I’d like to get tested.
Your ongoing health is important, especially during the COVID-19 pandemic. If you wish to do so, you should get an HIV test as soon as possible. If you are HIV-negative, there are options to prevent you from acquiring HIV, like pre-exposure prophylaxis (PrEP). If you test HIV-positive, highly effective treatments are available. Starting HIV treatment as early as possible after you are diagnosed – even the same day – can help you live a full and healthy life and prevent you from transmitting HIV to your sexual partners.
Where you can get an HIV test may vary depending on where you live. Try calling your doctor’s office, your local or state health department, or HIV organizations in your area and ask if it’s possible to get an HIV test. They will discuss with you the procedures to follow for getting a test as well as follow-up services. Home HIV tests are also available for purchase at your local drugstores or on Amazon for under $40.
I know I’m HIV-positive, and I want to get care and treatment services.
Your ongoing health is important, especially during the COVID-19 pandemic. A variety of healthcare services and highly effective treatments are available. Starting HIV treatment as early as possible after you’re diagnosed can help you live a full and healthy life, achieve well-suppressed (undetectable) viral load and prevent you from transmitting HIV to your sexual partners.
Where to find care and treatment services may vary depending on where you live. While many doctors’ offices, clinics, and HIV-service organizations may still have reduced or limited in-person services due to the COVID-19 crisis, telehealth (phone or video consultations), virtual benefits determinations and applications (including AIDS Drug Assistance Program enrollment) and laboratory services are often available. Try calling your doctor’s office, your local or state health department, or HIV organizations in your area and ask if it’s possible to begin services or start taking HIV medication. They will discuss with you the procedures to follow for beginning services and getting medication.
Check here to find a Ryan White Program provider in your area or call your local or state health department and explain to them you are HIV positive and would like to begin services and start HIV treatment.
Can I still access pre-exposure prophylaxis (PrEP)?
Many PrEP clinics are providing services using telehealth to meet with patients. PrEP providers may meet with you virtually on the phone or computer and then recommend that you go to a free-standing lab for HIV and STD screening or may order a home testing kit. Once confirmed to be HIV negative, CDC recommends that providers prescribe patients a 90-day supply of PrEP medication. The Ready, Set, PrEP program provides free PrEP medications to individuals without health insurance and assistance also is available through Gilead’s Advancing Access Program. The National Prevention Information Network has an online PrEP directory for help locating a PrEP clinic. Additional guidance on managing PrEP during the pandemic is available in a letter sent by the CDC to healthcare providers.
HIV MEDICATION ACCESS
What do I need to know about my HIV or other important medications during the COVID-19 crisis?
It is particularly important to keep taking your HIV medications as prescribed by your healthcare provider. It is also important to continue taking any other medications prescribed to prevent or treat other diseases or health problems.
At the same time, it is very important for all people to reduce their risk of contracting or spreading COVID-19 by following isolation requirements and social/physical distancing recommendations. This includes staying at home and avoiding public spaces (including pharmacies) as much as possible.
Is it safe to have sex during the outbreak?
Since the coronavirus is spread from person-to-person contact by droplets such as saliva or mucus, the safest approach during the outbreak is to not have sex with anyone else (except yourself). Limiting sex to your live-in or regular partner is safer sex during the pandemic. For safe sex tips and information, check out the New York City Health Department’s fact sheet on COVID-19 and sex, this one from the District of Columbia Department of Health, and this resource from The Well Project.
Most dating apps are also recommending that you not have sex with people outside of your household. Using dating apps to socialize and stay in touch with people without physically connecting with them is safe to do!
I am in recovery from an addiction. What should I do during this time?
It is important to continue your recovery plan if at all possible, during periods of physical or social isolation. Many recovery groups and 12-step programs have put in place online meetings. Check with your program’s website for more information and also be sure to check in with your mental health or substance use/recovery professional if at all possible.
Here’s a resource for people in recovery that you may find helpful.
Other important resources include this guide on COVID-19 for trans people from the National Center for Transgender Equality, these downloadable materials and messages from Greater Than AIDS, and an article in The Body.
Note from Dr. Hardy: I joined the FAM Board of Directors in June 2020. I returned home to Los Angeles after 4-years living in Washington, D.C., with my partner Barry, where I served as Senior Director of Research at Whitman-Walker Health. Having lived and worked as an HIV physician and researcher in Los Angeles since the early 1980s at UCLA, Cedars-Sinai and private practice, it was a treat to return to L.A.