Tuesday 10 March 2020
Update: 19 August 2020
Since the previous update, there have been a small number of studies addressing the outcomes of people living with HIV (PLHIV) during the COVID-19 pandemic. The quality of evidence informing this advice remains poor, and we are still awaiting large studies that would control for other factors known to increase COVID-19 risk.
At present, it DOES NOT appear that well-managed HIV infection is a risk factor for poorer COVID-19 outcomes. It is unknown if persons with AIDS, low CD4 cell counts, and/or detectable viral loads may be at elevated risk of COVID-19 acquisition or increased severity [1, 2]. Additional risk factors for COVID-19 (such as male sex, advanced age, smoking, diabetes, cardiovascular disease, and others) may disproportionately affect PLHIV.
Despite the lack of direct evidence, and until more is known, the US Department of Health and Human Services, British HIV Association, and European AIDS Clinical Society advise increased caution for persons with detectable viral loads or CD4 cell counts >200.
We continue to advise all PLHIV to take precautions against COVID-19, like all communities in Aotearoa New Zealand. These precautions include good hand hygiene practices, masks when appropriate, physical distancing, and seeking testing if cold or flu symptoms appear.
 Cooper, T., Woodward, B., Alom, S. and Harky, A. (2020). Coronavirus disease 2019 (COVID‐19) outcomes in HIV/AIDS patients: a systematic review. HIV Med. doi:10.1111/hiv.12911
 del Rio, C. (2020). COVID-19 in Persons Living with HIV — What Do We Know Today? NEJM Journal Watch. https://www.jwatch.org/na52137/2020/08/11/covid-19-persons-living-with-hiv-what-do-we-know-today
Update: 3 April 2020
During New Zealand's level 4 lockdown people living with HIV continue to have access to treatment – we recommend maintaining a 30-day supply of antiretroviral medication. Call or e-mail your medical provider to make arrangements if your medications are about to run out within a month.
Update: 22 March 2020
To keep COVID-19 community transmissions as low as possible, experts are recommending social distancing (click here for some easy visual information about how that can keep us safe).
While COVID-19 isn't a sexually transmitted infection, sex will bring you in very close contact to other people and heighten the risk of transmission. As such, we strongly encourage everyone to not engage in casual sex at present, regardless of HIV status.
Sex is an important part of life, and this doesn't mean all sexual activity needs to cease. Click here for some safe and sexy activity ideas.
Updated: 25 March 2020
If you or someone you know is living with HIV, you may have additional concerns around the risk of infection with the new coronavirus (SARS-CoV-2), which is the virus behind the COVID-19 disease.
Following the key scientific international conference, CROI 2020, and expert advice, there remains no evidence to determine whether people living with HIV are at greater risk of acquiring the new coronavirus or developing more severe disease as a result of that infection.
The British HIV Association (BHIVA) advises that to date, the main risk factors for developing more severe disease and risk of death are older age and co-morbidities, including cardiovascular diseases, renal diseases and diabetes.
The US Department of Health and Human Services (DHHS) advises that prior to effective antiretroviral therapy, CD4 cell counts of less than 200 cells/mm3 were a risk factor for respiratory infections, but the implications for Covid-19 are not yet clear.
We recommend that PLHIV have received influenza and pneumococcal vaccination, in line with local vaccine guidelines.
Make sure you have sufficient supply of antiretroviral and other medication. Based on New Zealand expert advice, we recommend maintaining a supply of at least 30 days, at all times. Talk to your treatment team about accessing appointments and medication, while New Zealand remains on high levels of Covid-19 alert.
There have been media reports on the use of lopinavir and ritonavir in trials to treat Covid-19. To date, there is insufficient evidence that any HIV treatments are effective in treatment or prevention of Covid-19. It is not recommended to switch medications, unless it is in the context of a clinical trial and following the advice of an HIV specialist.
Data relating to new coronavirus and who is most at risk is limited, but will continue to be updated as more transmissions occur. NZAF will continue to review the evidence for people living with HIV as it emerges.
Remember that any sexual contact is close contact, and therefore high risk for contracting or passing the virus causing Covid-19. Keep yourself and others safe.
Some members of our communities may be under more stress than others due to the evolving news – take care of your mental health and be kind and patient with yourself and people around you. Self-isolation can be a trying time. If you or your close ones need to self-isolate, make sure you maintain healthy connections with others, even if that is only possible remotely.
If you feel you are not coping, it is important to know you can talk with a health professional. For support with grief, anxiety, distress or mental wellbeing, you can call or text 1737 – free, anytime, 24 hours a day, 7 days a week – to talk with a trained counsellor.
It’s recommended that everyone, regardless of HIV status, follows the Ministry of Health everyday preventive actions:
- Cough or sneeze into your elbow or by covering your mouth and nose with tissues.
- Put used tissues in the bin or a bag immediately.
- Wash your hands with soap and water often (for at least 20 seconds).
- Try to avoid close contact with people who are unwell.
- Don’t touch your eyes, nose or mouth if your hands are not clean.
- Avoid personal contact, such as kissing, sharing cups or food with sick people.
- Clean and disinfect frequently touched surfaces and objects, such as doorknobs.
- Stay home if you feel unwell.
- Call Healthline on 0800 358 5453 if you have any symptoms and have been to any countries or territories of concern or have been in close contact with someone confirmed with COVID-19.