COVID-19 People Living With HIV

Thanks for visiting our HIV advocacy page. As we fight together to overcome the COVID-19 pandemic, it is important to stay safe and educated. Knowledge is power, so during these trying times, we want to provide you with reliable resources that can inform you or point you in the right direction for services.

The LGBTQ family has experienced pandemics before, there is no doubt of the many similarities between HIV and this new viral threat. As we have done with HIV, the best approach is to listen to healthcare professionals and their recommendations. If you have any further questions do not hesitate to email our HIV Advocacy Coordinator [email protected]

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Are there unique risks for PLWH related to COVID-19?

Yes, if their immune system is compromised. A PLWH who is in treatment and whose immune system has not been compromised by HIV is not at an increased risk for illness. They have the same risk factors for medical complications from COVID-19 as anyone else and data shows the progression of the virus is the same for them as for the general population. However, someone immuno-compromised or with underlying medical conditions is at a greater risk of developing severe symptoms. If you know that your immune system is compromised for any reason, including HIV, it is extremely important to take every precaution to avoid contracting the virus.^{^[1]}

Additionally, even if you are a PLWH who is undetectable with a healthy immune system,it is still important to take extra precautions regarding COVID-19 because of the dangerous role stigma may play in medical treatment during this crisis. While we are fighting HIV related stigma every day, the reality is that it still exists. PLWH need to be extra vigilant around healthcare professionals who may classify their HIV status as an underlying medical condition in order to make decisions about care.

Remember that hospital visits are not an option at this time and you must be ready to advocate for yourself in these uncertain times. PLWH need to use great care to avoid transmission.

PLWH should continue to maintain a healthy lifestyle that promotes a robust immune system like active movement, eating a balanced diet, restful sleeping, and reducing stress. Over half of the PLWH in FL are aged 50+ up which is a high-risk age group.^{^[2]} Lastly, research tells us that living with HIV can increase social isolation, depression, and substance abuse. In this crisis, all of these factors can be exacerbated. Any person, including PLWH, with underlying medical conditions, needs to be more vigilant and if they contract the virus are more likely to experience severe complications from COVID-19.

Are there greater risks for PLWH who are not currently on HIV medications?

Yes. People who are not on antiretroviral medication (ART) run the risk of compromising their immune system, increasing the chances of acquiring a plethora of conditions. If you have been diagnosed with HIV, it is imperative that you seek treatment that will keep your HIV at undetectable levels, your immune system healthy, and in turn, you protect others and the community at large. This is especially true right now because a compromised immune system can greatly increase the chances of developing severe complications of COVID-19. If you are living with HIV and you are not in treatment this is the time to start.

Can HIV medication treat or prevent COVID-19?

No. As of the drafting of this report, there is no evidence that HIV medications like ART (antiretroviral therapy) for HIV can prevent transmission of COVID-19. Although there are certain HIV medications that are being investigated^{^[3]} in combination with other drugs, to treat people who contracted COVID-19, as of the development of this report, there are no certified therapeutics available to treat COVID-19.

Can Pre-Exposure Prophylaxis (PrEP) protect me from COVID-19?

No. There is no evidence that PrEP medication can prevent the transmission of COVID-19.

There is a lot of discussion in the news about immuno-compromised people and COVID-19. Are PLWH considered immuno-compromised? What if someone is undetectable?

It depends. People living with HIV who are on antiretroviral medication and undetectable are not considered immuno-compromised. People living with HIV who are not on medication, have other underlying health conditions, or are part of the aging population (65+)^{^[4]} are considered immuno-compromised. People with these experiences are at higher risk of contracting the virus and may suffer more severe complications if they do contract COVID-19.

Can I get HIV care and medication if I lost my job and health insurance?

Yes. The Ryan White Program^{^[5]} is a federally funded program that provides basic HIV care and HIV medications accessed through the state of Florida’s AIDS Drugs Assistance Program. Equality Florida has reached out to, and will continue to stay in touch with, leading agencies providing Ryan White Services in Florida and most are communicating they remain open for business. See Question 8 below for a sampling list of the agencies that provide those services and continue to service clients.

Will I continue to receive Ryan White HIV/AIDS program benefits during the crisis?

Yes. The Department of Health continues to offer services for the Ryan White Program. Check with your local Department of Health for special instructions during the crisis. Telehealth and online services and appointments are being offered by regional offices and HIV focused organizations with Ryan White case managers.

Will HIV/STI/PrEP testing and services be available?

It depends. Most service providers are continuing test services during the epidemic without compromising social distance. Most testing locations are making accommodations to continue to offer services, through the COVID-19 health crisis. Check with your local Department of Health or preferred provider for special instructions on times of operations and available locations.

You can find more information about some of the Florida direct service providers listed here:

Will COVID-19 cause a shortage of HIV/PrEP medication?

No. At the time of this report, there are no medication shortages identified.^{^[6]} For PLWH or on PrEP it is recommended to have a 30-day supply of medication or 90 days, if possible, to avoid any disruptions in treatment. It is important to note that this is still a developing situation and access to medications can be delayed during this health emergency. In the event that you are hospitalized, make sure that you bring your HIV medication with you.

How can I get tested without risking contracting COVID-19/Coronavirus?

Most testing agencies are taking precautionary measures to ensure your safety and those of the providers. For example, pre-screening guests for symptoms and clients to reduce exposure, while also practicing social distancing before and after administering HIV/STI or COVID-19 tests. Call your preferred provider before making any decisions to visit a testing location.

Is it okay to have sex?

No. Having sex is a high-risk activity for the transmission of COVID-19 because of close contact with the other person. If you are self-isolating with a partner and you choose to have sex, you are probably at the same risk of transmission as you would be doing any number of things from sharing utensils to holding hands to kissing. If you have been self-isolating for 14 days or longer and neither of you has symptoms then the chances either of you have the virus are much lower. Sex with others who are not self-isolating or practicing social distance puts you at a high risk for contracting the virus. People who have contracted COVID-19 might not show symptoms right away due to the incubation period or may be asymptomatic yet still be able to transmit COVID-19. Phone sex, virtual sex, masturbation, and abstinence are all safe options - stick with that for now!

Now is the time to use a valuable lesson we have learned from our long battle with HIV - treat everyone, as though they have the virus, including yourself. Don’t do anything you wouldn’t do if you knew the other person had COVID-19, and don’t ask anyone to take a risk you wouldn’t ask them to take if you knew you had the virus.

Is COVID-19 stigma a problem?

Yes. Stigma related to health conditions that are transmitted between humans with high contagion rates increases misinformation and undue attacks on those perceived to be responsible for the outbreak (i.e. referring to COVID-19 as the Chinese Virus) and harkens back to some of the worst experiences of people living with HIV (i.e. referring to HIV as GRID or Gay Related Immune Deficiency.) Regardless of the origin of any disease, we must remember to practice kindness to others and stress, diseases are not to blame on any specific person or group.

While we do not want to raise unnecessary fear, the threat of HIV stigma affecting healthcare workers and healthcare decisions is a real concern. Medical experts agree that HIV status alone should not be treated as an underlying health condition by hospitals and we are working with several government agencies to elevate this crucial information.

We are working on a statement that makes clear that doctors should never use HIV status alone as a reason for rationing medical care and we recommend anyone living with HIV print out a copy of this document and take copies with you if you have to go to the hospital. Please also contact us immediately if you or a loved one’s medical care is rationed because of HIV status.

What are some precautions we should take at home to prevent COVID-19?

Current evidence suggests that novel coronavirus may remain viable for hours to days on surfaces made from a variety of materials. The virus is viable for up to 72 hours on plastics, 48 hours on stainless steel, 24 hours on cardboard, and 4 hours on copper. It is also detectable in the air for three hours.^{^[7]} Cleaning of surfaces followed by disinfection is a best practice measure for the prevention of COVID-19 and other viral respiratory illnesses in households and community settings. For more detailed tactics for how to prepare your home check the Center for Disease Control website for more detailed information.^{^[8]}

My city or county has enacted a “Stay at Home” directive. What does that mean for my HIV care?

It depends. Cities and counties are taking the lead in establishing restrictions on travel and activity outside the home, including directives about sheltering-in-place or staying at home. While nearly universally these directives create exceptions for accessing healthcare, it may complicate accessing public transportation or could affect the hours or accessibility of your healthcare provider. Call your medical provider before any decisions regarding your health, including doctor visits or ER trips.

Does federal relief funding legislation affect HIV funding?

In development. Congress has already put forward relief legislation and continues to work on additional measures to support recovery efforts for the COVID-19 epidemic. These are complex measures that are evolving at the time of this writing. We will continue to analyze and monitor this legislation and ensure that the needs of people living with HIV are being considered. At the time of this report, the Supplemental Appropriations Committee approved 90 million dollars towards Ryan White and 65 million dollars for Housing Opportunities for People Living with AIDS (HOPWA).

Are there any services for people dealing with substance dependency during the crisis?

Yes. We recognize the importance of recovery. The Substance Abuse Mental Health Services Association (SAMHSA^{^[9]}) have a list of resources for those who are struggling with substance use/abuse or in recovery. Also, there are support groups online that do peer-to-peer counseling as well as Facebook groups dedicated to “virtual meetings.”

It is also important to note that COVID-19 could be an especially serious threat to those who smoke tobacco or marijuana or who vape. People with opioid use disorder (OUD) and methamphetamine use disorder may also be vulnerable due to those drugs’ effects on respiratory and pulmonary health. Additionally, individuals with a substance use disorder are more likely to experience homelessness or incarceration than those in the general population, and these circumstances pose unique challenges regarding the transmission of the virus that causes COVID-19.^{^[10]}

What happens if I get arrested during this crisis?

In the event that you get arrested and cannot post bail. The Freedom Fund posts bail to secure the safety and liberty of people in jail and immigration detention with a focus on LGBTQ people. For those in need, they provide case management and medical-legal-social services linkages. You can fill out an application here.

¹ “COVID-19: What people with HIV should know”. Center for Disease Control. https://www.cdc.gov/coronavirus/2019-ncov/specific-groups/hiv.html

² US Statistics: https://www.hiv.gov/hiv-basics/overview/data-and-trends/statistics

³ https://www.sciencenews.org/article/coronavirus-pandemic-hiv-drugs-do-not-work-treatment-clinical-trial

⁴“COVID-19: What people with HIV should know”. Center for Disease Control. https://www.cdc.gov/coronavirus/2019-ncov/specific-groups/hiv.html

⁵ http://www.floridahealth.gov/diseases-and-conditions/aids/patient-care/eligibility-information1.html

⁶ “COVID-19: What people with HIV should know”. Center for Disease Control. https://www.cdc.gov/coronavirus/2019-ncov/specific-groups/hiv.html

⁷ How Long Can the Virus that Causes COVID-19 Live on Surfaces?: John Hopkins University. https://hub.jhu.edu/2020/03/20/sars-cov-2-survive-on-surfaces/

⁸ “Interim Recommendations for US Households with Suspected/Confirmed Coronavirus Disease 2019” CDC. https://www.cdc.gov/coronavirus/2019-ncov/prepare/cleaning-disinfection.html

⁹ SAMHSA Resources & Information https://www.samhsa.gov/coronavirus

¹⁰ COVID-19: Potential Implications for Individuals with Substance Use Disorders. National Institute on Drug Use https://www.drugabuse.gov/about-nida/noras-blog/2020/03/covid-19-potential-implications-individuals-substance-use-disorders

Spanish Version

https://www.cdc.gov/coronavirus/2019-ncov/specific-groups/hiv.html (CDC)

https://www.poz.com/article/people-hiv-need-know-new-coronavirus (Poz Mag)

https://www.sciencenews.org/article/coronavirus-pandemic-hiv-drugs-do-not-work-treatment-clinical-trial (Science News)

https://hab.hrsa.gov/coronavirus-frequently-asked-questions

http://broward.floridahealth.gov/programs-and-services/infectious-disease-services/hiv-aids/patient-care/ryan-white/index.html

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http://www.floridahealth.gov/diseases-and-conditions/aids/patient-care/hopwa.html (FLDOH)

https://www.hudexchange.info/programs/hopwa/ (HUD)

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https://www.who.int/emergencies/diseases/novel-coronavirus-2019/advice-for-public/myth-busters (WHO)

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https://gettested.cdc.gov/ (CDC)

https://knowyourhivstatus.com/get-tested/ (FLDOH)

https://heymistr.com/26health/ (26Health - MISTR)

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https://support.therapytribe.com/ (Free Service)

https://www.pwn-usa.org/pwncares/pwncares-sister-circle/ (women-focused)

26Health: Care for Every Letter, is hosting several online support and recovery groups for FREE. Please visit our landing page here: https://www.26health.org/copingwithcovid-19

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