SEATTLE, Washington — The current global health crisis has been anything but convenient. While the developed world has struggled with this disruption, the vulnerable global communities have been hit more aggressively. In impoverished countries where infrastructure is already less established than that of a wealthier nation, resource shortages further inhibit the abilities to effectively treat the sick. For the global HIV community, governments are urging people to take health precautions. The HIV community must take these precautions on top of the ones they are already practicing concerning HIV.
TheBody is a host of reliable HIV/AIDS health information, operating since 1995. It has been keeping the community abreast of news relating to how COVID-19 might affect those with HIV. The Borgen Project interviewed Kenyon Farrow, the senior editor for TheBody. He talked about what COVID-19 means for the HIV community.
According to Farrow, as far as anyone knows there are no specific, direct risks to those with HIV contracting COVID-19. Currently, there is nothing that indicates those with HIV are more at risk for COVID-19. Whether or not it is more dangerous it is for someone with HIV to contract COVID-19 is largely dependent on how accessible treatment for HIV is for that individual. Factors like whether the virus is suppressed and one’s T-cell count impact how robust someone’s immune system is. This will determine how well that individual can fight infection.
Suppressing the virus greatly lessens the risk of transmission. Around 50% of the HIV community within the U.S. is virally suppressed. However, in developing countries, 92% of the HIV community would benefit from, but do not have access to, antiretroviral drugs. Sub-Saharan Africa, a region home to some of the world’s poorest countries, is where the HIV epidemic is the worst. As of July 2019, 7% of adults living in the region are living with HIV. Furthermore, there were 310,000 AIDS-related deaths.
The Lack of Resources
The underlying issue of accessibility to efficient healthcare exacerbates the disparity of what the global HIV community needs amid this global health crisis. Farrow points out that in wealthier nations like the U.S., physicians have increased teleconsultations since people with HIV and other such chronic health conditions see the doctor more often than others. However, in developing countries, people not be able to afford to visit their doctor. Furthermore, they might not have the resources to have a teleconsultation.
Farrow also says that access to healthcare, specifically for those with HIV, can be more difficult if someone is not already engaged with the system. HIV is a highly stigmatized disease, which tends to inhibit the newly diagnosed from seeking treatment. “They’re already frightened and scared,” Farrow said, “and might be fearful of leaving home to make an appointment to see a doctor during the COVID-19 pandemic.”
In impoverished countries, this may be aggravated by less developed healthcare systems where consistency is hard to maintain. People struggle to earn enough to meet their daily needs let alone get tested and begin treatment.
HIV and COVID-19
Farrow believes that the world’s experience with HIV has a lot to offer when thinking of the response to COVID-19. “We lack adequate testing to determine the real prevalence rate,” said Farrow. “We only know about the people sick enough to be portioned out a test.” With HIV, there were 40 years of development of tests for antibodies. Now, there are several generations of tests for acute infection.
Farrow asserts that those who have worked in HIV research and implementation science have a lot to offer in how to model a response to COVID-19. They can offer perspective on various components, such as how many tests are needed, how people are tested and how those who are infected can efficiently move into care without waiting until they are visibly “sick enough” to warrant action.
While from a scientific standpoint, there is a lot the COVID-19 response can learn from the HIV response, there are other parallels present that aren’t as hopeful. If HIV sets up precedence to how the COVID-19 health crisis will go with respect to the distribution of resources for testing and treatment around the globe, impoverished countries will still suffer the brunt of the consequences. HIV is still ravaging the poorer areas of the world, and COVID-19 bodes similar grave consequences if a proactive global response is not enacted.
The International AIDS Society (IAS)
IAS has already made co-infections and co-morbidities a priority in its initiative against HIV/AIDS. It uses the intersectionality of issues to not only broaden the scope of people it helps but also to maintain the momentum of improving the quality of life for people living with HIV. As HIV targets the immune system, fighting HIV in tandem with other diseases and infections has been a priority within the HIV/AIDS community since before COVID-19. Despite the fact that AIDS-related deaths have decreased by 45% since 2005, one million people still die annually from health issues further complicated by AIDS.
As the number of people living with HIV grows, the number of people aging and developing non-communicable diseases alongside HIV is also growing. In studying the co-morbidities of chronic conditions, non-communicable diseases and HIV, IAS believes that healthcare systems and governments can start investing in the younger population living with HIV to proactively combat this co-morbidity.
HIV/AIDS as an issue isn’t just HIV/AIDS, it’s also the infections and health conditions those living with HIV can contract afterward. In the U.S., many HIV resources have been calling for those living with the disease to be proactive. Hopefully, they will ensure that they have an ample supply of their medication to mitigate the need to go out as well as maintain contact with a healthcare provider. For those living in areas where healthcare is less accessible, these steps might be less feasible. Efforts and initiatives like those undertaken by the IAS are important not just for handling HIV/AIDS co-infections as a health issue but in understanding access to effective healthcare as a human right.
– Catherine Lin