COVID-19 CONSIDERATIONS

Coronavirus, COVID-19, and Considerations for People Living with HIV and LGBTQIA+ People

Overview

  • COVID-19 is a respiratory infection that can spread from person to person through droplets from coughing or sneezing.

  • These droplets can land in the mouths or noses of people who are nearby or possibly be inhaled into the lungs. The droplets can also persist on surfaces for hours.

  • Symptoms of COVID-19 include fever, cough, and shortness of breath. While most people have mild symptoms, some people are at higher risk of getting very sick from COVID-19.

  • Some individuals may acquire this infection and not get sick, others may have mild symptoms, but a subset of people develop life-threatening respiratory disease.

Who is at Risk?


  • The virus is highly contagious and threatens everybody in terms of its infectiousness. That said, there are some groups that are particularly vulnerable to developing serious complications:
  • Older adults (over 65) and people who have chronic medical conditions like HIV, heart disease, diabetes, and lung disease may have a higher risk of complications from COVID-19.
  • In the United States, nearly half of people with diagnosed HIV are aged 50 and older. People with HIV also have higher rates of chronic heart and lung disease. Like other respiratory infections among people with HIV, the risk of getting very sick is greatest in people with a low CD4 cell count and people not on HIV treatment.
  • People who are taking medicine to treat or prevent HIV should stick to their treatment plan, continue taking their medicine consistently, and follow the advice of their health care provider.
  • Encouraging people with HIV to stay on treatment and take preventative actions will play an essential role in protecting the health and well-being of those who are at higher risk of serious illness from COVID-19.
  • People with HIV who have COVID-19 have an excellent prognosis, and they should be clinically managed the same as persons in the general population with COVID-19, including when making medical care triage determinations.




What Can You Do To Reduce Your Risk Of Becoming Infected?


  • Clean your hands often!
    • Wash your hands often with soap and water for at least 20 seconds especially after you have been in a public place, or after blowing your nose, coughing, or sneezing.
    • If soap and water are not readily available, use a hand sanitizer that contains at least 60% alcohol. Cover all surfaces of your hands and rub them together until they feel dry.
    • Avoid touching your eyes, nose, and mouth with unwashed hands.
  • Avoid close contact:
    • Avoid close contact with people who are sick
    • Put distance between yourself and other people if COVID-19 is spreading in your community. This is especially important for people who are at higher risk of getting very sick.
  • Take steps to protect others:
    • Stay home if you are sick, except to get medical care.
  • Cover coughs and sneezes:
    • Cover your mouth and nose with a tissue when you cough or sneeze or use the inside of your elbow.
  • Throw used tissues in the trash:
    • Immediately wash your hands with soap and water for at least 20 seconds. If soap and water are not readily available, clean your hands with a hand sanitizer that contains at least 60% alcohol.
  • Wear a facemask if you are sick or sneezing or coughing:
    • If you are sick: You should wear a facemask when you are around other people (e.g., sharing a room or vehicle) and before you enter a healthcare provider’s office. If you are not able to wear a facemask (for example, because it causes trouble breathing), then you should do your best to cover your coughs and sneezes, and people who are caring for you should wear a facemask if they enter your room.
    • If you are NOT sick: You do not need to wear a facemask unless you are caring for someone who is sick (and they are not able to wear a facemask). Facemasks may be in short supply and they should be saved for caregivers.
    • If you don't have a facemask, making them are easy. Here's how you can make your own DIY facemask
  • Clean and disinfect:
    • Clean AND disinfect frequently touched surfaces daily. This includes tables, doorknobs, light switches, countertops, handles, desks, phones, keyboards, toilets, faucets, and sinks.
    • If surfaces are dirty, clean them: Use detergent or soap and water prior to disinfection.




What Can You Do To Help Yourself and Others Cope?


Reject Stigma! Do not scapegoat or blame groups of people Despite the claims of some irresponsible leaders, the coronavirus is not the fault of any one country or racial/ethnic group. Viruses are part of our world and our shared human history.

As LGBTQIA+ people and/or people living with HIV, we know how HIV stigma and anti-LGBTQIA+ stigma can enable the spread of HIV. It’s important not to stigmatize the coronavirus.

No single racial or ethnic group of people is at greater risk of contracting or spreading the virus. The virus knows no borders and does not discriminate. Racism and xenophobia, including anti- Chinese and anti-Asian racism, are not helpful responses.

Stigma can also occur after a person has been released from COVID-19 quarantine even though they are not considered a risk for spreading the virus to others.

It is important to remember that people – including those of Asian descent who do not live in or have not recently been in an area of ongoing spread of the virus that causes COVID-19, or have not been in contact with a person who is a confirmed or suspected case of COVID-19 are not at greater risk of spreading COVID-19 than other Americans. Manage Your Anxiety and Stress The outbreak of coronavirus disease 2019 (COVID-19) may be stressful for people. Fear and anxiety about a disease can be overwhelming and cause strong emotions in adults and children. Coping with stress will make you, the people you care about, and your community stronger. Everyone reacts differently to stressful situations. How you respond to the outbreak can depend on your background, the things that make you different from other people, and the community you live in.

  • If you, or someone you care about, are feeling overwhelmed with emotions like sadness, depression, or anxiety, or feel like you want to harm yourself or others call 911
  • Substance Abuse and Mental Health Services Administration’s (SAMHSA’s) Disaster Distress Helpline: 1-800-985-5990 or text TalkWithUs to 66746. (TTY 1-800-846-8517)
Remain Hopeful! Finally, it’s important to practice self-care and remain hopeful. We are in for a long haul, but we will get through this together if we take the appropriate precautions and make sacrifices now for the greater societal good. Here are some ideas to help get you and the people you love through this:
  1. Take breaks from watching, reading, or listening to news stories, including social media. Hearing about the pandemic repeatedly can be upsetting.
  2. Take care of your body. Take deep breaths, stretch, or meditate. Try to eat healthy, well-balanced meals, exercise regularly, get plenty of sleep, and avoid alcohol and drugs.
  3. Make time to unwind. Try to do some other activities you enjoy.
  4. Connect with others. Talk with people you trust about your concerns and how you are feeling.
  5. Check in on isolated individuals, especially people who are elderly or people living with a disability or chronic disease.




COVID-19 Resources


CDC.gov/coronavirus This site provides the latest public health and safety information on COVID-19 from CDC for consumers and the overarching medical and health provider community. HRSA.gov/coronavirus This page provides COVID-19 information specific to HRSA programs and grantees. RWHAP COVID-19 Frequently Asked Questions These FAQs were developed to assist RHWAP recipients, subrecipients, and stakeholders as they deliver critical services and assist local communities in response to COVID-19. This page is updated regularly. HIVinfo.NIH.gov Interim guidance for COVID-19 and persons living with HIV. The information in the brief version is excerpted directly from the full-text guidelines. The brief version is a compilation of the tables and boxed recommendations.





COVID-19 Resources

What can people do with HIV to protect themselves from COVID-19?


People with HIV should take everyday preventive actions to help prevent the spread of COVID-19. People with HIV should also continue to maintain a healthy lifestyle. This includes:

Staying healthy helps your immune system fight off infection should it occur. If you have HIV and are taking your HIV medicine, it is important to continue your treatment and follow the advice of your health care provider. This is the best way to keep your immune system healthy.




Are people with HIV at higher risk for COVID-19 than other people?


We are still learning about COVID-19 and how it affects people with HIV. Based on limited data, we believe people with HIV who are on effective HIV treatment have the same risk for COVID-19 as people who do not have HIV. Older adults and people of any age who have serious underlying medical conditions might be at increased risk for severe illness. This includes people who have weakened immune systems. The risk for people with HIV getting very sick is greatest in:

  • People with a low CD4 cell count and
  • People not on effective HIV treatment (antiretroviral therapy or ART).




Are COVID-19 vaccines safe for people living with HIV?


The U.S. vaccine safety system makes sure all vaccines are as safe as possible. COVID-19 vaccines have gone through the same safety tests and meet the same standards as other vaccines. People with HIV were included in clinical trials, though safety data specific to this group are not yet available. People with HIV are part of the group of people with underlying medical conditions. If you have HIV, you may choose to get vaccinated if you have not had a severe or immediate allergic reaction to any of the vaccine ingredients. If you have a weakened immune system, you should also be aware of the potential for reduced immune responses to the vaccine. If you decide to get vaccinated, continue to take everyday preventive actions to protect yourself against COVID-19. Learn more about what CDC and other federal partners are doing to make sure COVID-19 vaccines are safe and effective.




What should I do if I think I may have COVID-19?


Call your health care provider if you develop symptoms that could be consistent with COVID-19. Discuss how to get evaluated and how to avoid potentially exposing others to COVID-19. Learn more about COVID-19 and what to do if you get sick.




What else can people with HIV who are at a higher risk of getting sick with COVID-19 do to protect themselves?


Nearly half of people in the United States with diagnosed HIV are aged 50 years and older. People with HIV also have higher rates of certain underlying health conditions. Both increased age and these conditions can increase their risk for more severe illness if people with HIV get COVID-19, especially people with advanced HIV. Steps that people with HIV can take to prepare in addition to what is recommended for everybody:

  • Make sure you have at least a 30-day supply of your HIV medicine and any other medications or medical supplies you need for managing HIV.
  • Talk to your health care provider and make sure all your vaccinations are up-to-date, including vaccinations against seasonal influenza and bacterial pneumonia because these vaccine preventable diseases disproportionally affect people with HIV.
  • Establish a plan for clinical care if you have to stay at home for a couple of weeks. Try to establish a telemedicine link through your HIV care provider’s online portal. If telemedicine is not available to you, make sure you can communicate with your provider by phone or text.
  • Make sure you can maintain a social network remotely, such as online, by phone, or by video chat. This can help you stay socially connected and mentally healthy, which is especially important for people with HIV.
  • People with HIV can sometimes be more likely than others to need extra help, from friends, family, neighbors, community health workers, and others. If you become sick make sure you stay in touch by phone or email with people who can help you.




Can HIV medicine (ART's) be used to treat COVID-19?


Currently, treatment for COVID-19 is very limited. There is no evidence that any medicines used to treat HIV are effective against COVID-19. People with HIV should not switch their HIV medicine in an attempt to prevent or treat COVID-19. Some clinical trials are looking at whether HIV medicines can treat COVID-19. Other trials are looking at the effectiveness of different drugs to treat COVID-19 in people with HIV. They are also looking to better understand how people with HIV manage COVID-19. You can learn more at ClinicalTrials.gov .




Should people with HIV travel at this time?


For the latest CDC travel recommendations, visit CDC’s COVID-19 travel information page.




What can everyone do to minimize stigma about COVID-19?


Minimizing stigma and misinformation about COVID-19 is very important. People with HIV have experience in dealing with stigma and can be allies in preventing COVID-19 stigma. Learn how you can reduce stigma and help prevent the spread of rumors about COVID-19.




Are shortages of HIV medicines (ART's) or Pre-Exposure Prophylaxis (PrEP) expected?


Drug shortages or anticipated problems with HIV medicine have not been identified. The U.S. Food and Drug Administration (FDA) is closely monitoring the drug supply chain, as the COVID-19 pandemic has the potential to disrupt the supply of medical and pharmaceutical products in the United States. The National Alliance of State and Territorial AIDS Directors (NASTAD) has also remained in contact with the major manufacturers of HIV medicine, as many of these products rely on ingredients produced in other countries. As of January 26, 2021, there were no reports of manufacturing concerns or supply shortages of ART or PrEP. Learn more about the FDA’s response to COVID-19.