COVID-19 CONSIDERATIONS

We are still learning about COVID-19 and how it affects people with HIV. Based on limited data,(https://www.cdc.gov/coronavirus/2019-ncov/need-extra-precautions/evidence-table.html) 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 (https://www.cdc.gov/coronavirus/2019-ncov/need-extra-precautions/people-at-increased-risk.html)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).

People with HIV should take everyday preventive actions (https://www.cdc.gov/coronavirus/2019-ncov/need-extra-precautions/people-at-higher-risk.html#take-everyday-precautions)to help prevent the spread of COVID-19. People with HIV should also continue to maintain a healthy lifestyle. This includes: • Eating right • Getting at least 8 hours of sleep, and • Reducing stress as much as possible.(https://www.cdc.gov/coronavirus/2019-ncov/daily-life-coping/managing-stress-anxiety.html) 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.

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.(https://www.cdc.gov/coronavirus/2019-ncov/vaccines/recommendations/underlying-conditions.html) If you have HIV, you may choose to get vaccinated if you have not had a severe or immediate allergic reaction (https://www.cdc.gov/coronavirus/2019-ncov/vaccines/safety/allergic-reaction.html)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 (https://www.cdc.gov/coronavirus/2019-ncov/prevent-getting-sick/prevention.html)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 (https://www.cdc.gov/coronavirus/2019-ncov/vaccines/safety.html)and effective.(https://www.cdc.gov/coronavirus/2019-ncov/vaccines/effectiveness.html)

Call your health care provider if you develop symptoms (https://www.cdc.gov/coronavirus/2019-ncov/about/symptoms.html)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.(https://www.cdc.gov/coronavirus/2019-ncov/if-you-are-sick/index.html)

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 (https://www.cdc.gov/coronavirus/2019-ncov/need-extra-precautions/people-at-higher-risk.html?CDC_AA_refVal=https%3A%2F%2Fwww.cdc.gov%2Fcoronavirus%2F2019-ncov%2Fhigh-risk%2Fhigh-risk-complications.htm)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 (https://www.cdc.gov/coronavirus/2019-ncov/prevent-getting-sick/index.html)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 (https://www.cdc.gov/flu/highrisk/hiv-flu.htm)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.

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(https://clinicaltrials.gov/ct2/home) .

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.(https://www.fda.gov/emergency-preparedness-and-response/counterterrorism-and-emerging-threats/coronavirus-disease-2019-covid-19)

For the latest CDC travel recommendations, visit CDC’s COVID-19 travel information page.(https://www.cdc.gov/coronavirus/2019-ncov/travelers/index.html)

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 (https://www.cdc.gov/coronavirus/2019-ncov/daily-life-coping/reducing-stigma.html)about COVID-19.