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People with HIV should not have a higher coronavirus risk if they take viral-suppressing drugs as usual, but many may struggle to get hold of medication

Coronavirus
  • Certain pre-existing medical conditions like cancer and HIV can significantly weaken someone’s immune system, making it more likely for some people to develop more severe symptoms of coronavirus.
  • People with “less-controlled HIV” — people who have HIV who aren’t receiving the proper treatment — are at risk for more dangerous symptoms. 
  • However, a person who is on successful HIV treatment is not at a higher risk for concerning symptoms of the virus, according to Bruce Richman, founder and executive director of the Prevention Access Campaign.
  • “The majority of the people with HIV who are not being adequately served by our healthcare system are the folks who are black, Latinx, transgender and other marginalized and low income communities,” Richman told Insider. “This is really highlighting the gross inequality in our health care system and in the US.”

The coronavirus pandemic is a concern for everyone around the world, but those with underlying medical conditions that affect the immune system have a significantly higher risk, medical experts warn.

One of those high-risk groups is people who have HIV.

According to experts, those who are on viral-suppressing drugs, known as anti-retroviral therapy, should not be more vulnerable to the virus than the general population.

However, many people with HIV, or those who have undiagnosed HIV, do not have access to treatment, which makes them much more likely to develop a severe case of COVID-19 as it spreads around the world, according to Bruce Richman, founding executive director of the Prevention Access Campaign.

“Viruses don’t discriminate, but inequality puts some communities at greater risk,” Harper Jean Tobin, director of policy for the National Center of Transgender Equality, told Insider. “Global pandemics don’t recognize lines of nationality, race, or gender, but the inequalities we live with every day make us all less safe.”

Since the first case of the virus was reported in December 2019, 127,000 people have been infected and 4,700 people have died worldwide. 

The virus tends to be more dangerous for the elderly — with the Centers for Disease Control and Prevention announcing March 9 that it recommends people 60 and older to stay home and socially distance to avoid infection. 

Not everyone living with HIV is immunocompromised — those with access to proper treatment do not have a higher coronavirus risk 

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Crystal Cox/Business Insider

 

While having HIV can render some people immunocompromised, if people have proper access to medications and take those medications religiously, they can live a healthy life. 

“When a person living with HIV is on successful treatment they can’t pass on HIV and typically have a healthy and strong immune system,” Richman told Insider. 

After six months of taking viral-suppressing drugs every day, a person’s viral load will be undetectable (to such an extent that it is even untransmissable to others). 

Unfortunately, there are massive disparities in the United States as to who has access to proper HIV care. Those who cannot afford consistent medication, healthcare, or shelter risk weakening their immune systems because they are not able to keep their CD4 cell, also known as T cell, count up. 

Without an adequate number of CD4 cells, the body has a weakened defense against viruses and infections, such as the novel coronavirus, which causes COVID-19, a severe respiratory disease. 

“Almost half of the 1 million people living with HIV in the United States are not receiving the treatment and care they need to stay healthy and not pass on HIV,” Richman told Insider. “The US is doing worse than any comparable high income country in caring for people with HIV.”

According to Richman, this disparity is the the result of the high cost of HIV medications along with structural and social challenges like homelessness, racism, poverty, and HIV stigma. 

The majority of people who are not able to access proper HIV treatment in the US come from marginalized communities

A person holds up a flag during rally to protest the Trump administration's reported transgender proposal to narrow the definition of gender to male or female at birth in New York (file photo).JPG
A person holds up a flag during rally to protest the Trump administration’s reported transgender proposal to narrow the definition of gender to male or female at birth in New York (file photo). 
REUTERS/Brendan McDermid

 

In 2019, President Donald Trump pledged to end HIV transmission by the year 2030.  

An estimated 160,000 Americans have undiagnosed HIV. Because of disparities that exist in both access to HIV treatment and STI testing, marginalized communities are disproportionately impacted by the spread of HIV in the US, and barriers to knowing their status. 

“The majority of the people with HIV who are not being adequately served by our healthcare system are the folks who are black, Latinx, transgender and other marginalized and low income communities,” Richman said. “These folks are not getting the care needed for HIV and they are also at greater risk for COVID-19 and other comorbidities.”

While this inequality has historically existed in the US, Richman said that the coronavirus pandemic is only emphasizing the need for accessible healthcare. 

“This is really highlighting the gross inequality in our health care system and in the US in general, and we will see the divide even more clearly when a vaccine, effective treatments or cure become available,” Richman said. 

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