COVID-19 and People Living with HIV

The LGBTQ community is no stranger to worldwide pandemics. It is not lost on me, in the middle of this Coronavirus (COVID-19) pandemic that I have also lived through the pandemic of HIV/AIDS. Lifesaving antiretroviral (ARV) medication has meant that persons are now living longer with HIV, but as these two pandemics collide, and persons were asked to self-quarantine in their homes, HIV positive persons found themselves caught between venturing out at the risk of contracting COVID-19, so as to able to get their life saving ARV medication. With nationwide lockdowns, the closure of none essential businesses, massive job and income loss and the disruption in the food supply chain, so many of the country’s most vulnerable found themselves ill equipped to weather the negative effects of the COVID-19 pandemic. “Lockdowns, curfews, economic restrictions and social isolation associated with the COVID-19 pandemic are having a disproportionate negative effect on vulnerable populations” (UNAIDS 2021). This includes persons living with HIV. Additionally, The Global Fund to Fight AIDS, Tuberculosis and Malaria (the Global Fund) reported massive decline in prevention measures due to COVID-19, as much as a 41% decline in testing and a 37% decline in referrals for diagnosis and treatment.

Not knowing your status is dangerous for people living with HIV. While doctors at the Medical Research Foundation of Trinidad and Tobago (MRFTT) assert that HIV positive persons who maintain adherence to their medication and manage their viral load do not fear any worse than HIV negative persons if they contract the COVID-19 virus, HIV positive persons who do not know they are HIV positive fear demonstratively worse.

Persons living with HIV appear to be at elevated risk of serious health complications due to COVID-19 infection. Data from the United States show that people living with HIV who acquired SARS-CoV-2 infection were much more likely to require hospitalization and suffer severe illness than people who were HIV negative, while studies from England and South Africa have found that the risk of dying from COVID-19 among people with HIV was double that of the general population (2021 UNAIDS Global AIDS Update).

Another spoke in the wheel of the COVID-19 response, is vaccine hesitation. Fueled by misinformation, this is scaring many persons living with HIV. For people who lived through the side effect of ARVs taking a gamble on the side effects of the COVID-19 vaccine, which include possible blood clots and death, it is no wonder that there is ambivalence about taking the jab. COVID-19 vaccines provide significant protection for persons living with HIV. The HHS Interim Guidance for COVID-19 and with HIV recommends that people who are HIV positive should receive COVID-19 vaccines, regardless of their CD4 or viral load. Clinical trials that included persons who are HIV positive have shown that AstraZeneca/Oxford, Johnson and Johnson, Moderna, Pfizer/BionTech, Sinopharm and Sinovac are safe for people living with HIV. 

I am old enough to remember a time before ARVs when attending the funerals of friends was a biannual event. I remember the social isolation I felt less from the risk of contracting HIV but more from the stigma and discrimination that kept me in the closet, afraid to make friends and isolating myself from my family. I also remember the misinformation about condom use. That even though public health communication promoted it as 99% effective, others preferred the narrative that “condoms were not 100% effective”. Then when medication became available to treat HIV/AIDS many would delay going on medication because they heard horror stories about the side-effects. However, not only are people living with HIV as a manageable lifestyle illness now, when properly adhered to, ARV medication reduce the viral load to undetectable levels that make HIV untransmittable. This is what is referred to as Treatment as Prevention. Persons who take their HIV medication as prescribed within twelve months can reduce their viral load to levels where it is not detectable in their blood and subsequently not able to transmit the virus to someone else. 

A healthy amount of doubt is good for any citizenry, but I take a very different approach when it comes to trusting the science. Friends For Life will virtually host our annual HIV Memorial on this Sunday August 1st. A mainstay for us during this commemorative event is the Photo Memorial Wall, a visual catalogue of individuals of the LGBTQ+ community, whom we would have lost to HIV/AIDS. Due to HIV medication, for the past decade the Memorial has been an event where I can come to celebrate with my brothers and sisters who are now LIVING with HIV. The fight against the HIV pandemic is not over. It is still ever so important to take measures to protect yourself from contracting HIV, know your status by getting tested regularly if you are sexually active and if you are HIV positive, follow your medication regimen. But also, Friends For Life encourages you to follow the WHO guidelines; wash your hands, wear- your mask properly, social distance and get vaccinated when you can. 

Written by: Luke Sinnette for a Friends For Life project with funding through the CARICOM-PANCAP/CVCCOIN Multi-Country Caribbean Regional Global Fund Project [GN 1838].