If I’m living with HIV, am I more at risk of COVID-19? Expand If you are undetectable, with a CD4 count over 200 (the last time it was checked), and otherwise healthy, there is currently no evidence to suggest that there is an increased risk of infection, or increased severity of illness from COVID-19. According to BHIVA, the first case series of people with COVID-19 who are HIV positive have been published. So far there is no evidence for a higher COVID-19 infection rate or different disease course in people living with HIV than in HIV-negative people (published April 30th). If you are not on treatment, have a CD4 under 200, or you have a detectable viral load, you will be at a higher risk of serious illness from COVID-19 – therefore you should be practicing physical distancing. Physical distancing is often called social distancing – you can get more advice here. People with other health conditions, such as heart, liver or kidney disease or a respiratory disease such as asthma, have a higher risk of more serious outcomes from COVID-19. Use physical distancing to reduce the chance of getting the virus, and minimise the risk of passing it on to other. The NHS considers you at high risk from COVID-19 if you: have had an organ transplant are having certain types of cancer treatment have blood or bone marrow cancer, such as leukaemia have a severe lung condition, such as cystic fibrosis or severe asthma have a condition that makes you much more likely to get infections are taking medicine that weakens your immune system are pregnant and have a serious heart condition If you are over 70, you should follow guidance on physical distancing too, to reduce the risk of you getting COVID-19. Physical distancing is also known as social distancing, and you can find out more about that by clicking here. If your CD4 count is under 50, or you've had an opportunistic infection within the last 6 months - you should take the government advice on shielding. For more on shielding, you can click here.
I’ve not had a CD4 test in ages, how do I know what it is? Expand THT’s Medical Director, Dr Michael Brady, said that if your CD4 count was over 200 at your last test, and you have been undetectable since then, your CD4 will be no worse, if not better. If your CD4 count is under 200, you should take on board advice on social distancing. You can find out more about that on NHS Inform’s website here.
What is physical distancing? Expand What is physical distancing? Physical distancing is about stopping the spread of COVID-19. It is often called social distancing - but we use the term physical distancing because we know it's important to maintain social links. Physical distancing means: Avoiding contact with someone who is displaying symptoms of coronavirus (COVID-19). These symptoms include high temperature and/or new and continuous cough. Avoiding non-essential use of public transport, varying your travel times to avoid rush hour when possible. Working from home, where possible. Your employer should support you to do this. Avoiding large gatherings, and gatherings in small public spaces such as pubs, cinemas, restaurants, bars and clubs (these are currently closed in the UK in order to mitigate such gatherings) Avoiding gatherings with friends and family. Keep in touch using remote technology such as phone, internet, and social media. Using telephone or online services to contact your GP, other essential services and your friends & family. You can find out more about that on NHS Inform’s website here.
My clinic or support service has changed – what can I do? Expand Many services are changing, and we’ll try and keep all the latest news here. You shouldn’t be concerned about changes, they are being made in everyone’s best interests whilst ensuring you still have the high quality of care and support you are used to. The Brownlee Clinic have issued some guidance for people living with HIV - this covers information about clinic appointments & who to contact - Click here to download. Waverley Care have suspended in-person support services. If you were accessing support, mechanisms have been put in place to allow you to continue. Check out their website for more information. Lothian Sexual Health have a dedicated website where you can find out information about their service. Check out their website for more information by clicking here.
My next appointment is by telephone, should I be concerned? Expand You shouldn’t be worried about your next appointment being over the telephone. The NHS is moving to telephone clinics to stop people having to go to the clinic, and to reduce the risk of transmitting COVID-19. By reducing the number of people coming in to the clinic, and reducing the appointment time, NHS staff can help out with caring for the most sick patients at this time. If you have any concerns, you should raise these with your clinic before the appointment. You will have received a text message with the best contact number.
What would happen if my bloods aren’t taken at this appointment? Expand You shouldn’t be worried about missing a blood test, if your doctor has agreed that it is safe to do so. Hopefully you’ll be able to get a blood test at your next regular appointment to check everything is as it should be. If there are any concerns, then you can discuss these with your clinician during your appointment.
Should I make sure that I have enough treatment? Expand The advice from the British HIV Association is to make sure that you have at least 30 days of treatment at home, if you normally get a prescription to take home. You should discuss your prescription with your doctor if you have any concerns.
How can I get my treatment if I’m not going into clinic? Expand If you have had a virtual clinic appointment, there are a few ways that you can get your treatment. Your clinician may discuss Homecare delivery with you – this is organised with a local pharmacy and delivered within three weeks after your appointment. You could go and collect your prescription from the clinic after your appointment. You can get someone to collect your prescription from the clinic on your behalf. If you’re having problems with getting your treatment, you should speak to your clinic first, or call HIV Scotland on 0131 558 3713 and we’ll try to help.
How can I tell my employer that I need to self-isolate or work from home? Expand You can get an isolation note from NHS 111 if you need to self-isolate because of COVID-19. You do not need to get a note from your GP. You can get an isolation note on the NHS website by clicking here. If you haven’t disclosed your HIV status to your employer, you may want to discuss this with them to arrange home-working or extended time off. The National AIDS Trust (NAT) have some help on their LoopedIn service for how to have conversations about HIV & COVID-19 with employers. You can find that information on their website by clicking here. Many people will not be able to tell their employer because of fear of stigma or discrimination. You should ask your doctor to give you a sick note that doesn’t disclose your status, but says you have a condition that is protected by the Equality Act. There's a great blog by the National AIDS Trust (NAT) with further employment advice, click here. If you need more advice about your employment, HIV & COVID-19, phone HIV Scotland on 0131 558 3713.
Does HIV treatment protect me from COVID-19? Expand No. There is no evidence HIV treatment prevents or treats COVID-19. Do not increase your regular dose to prevent or treat COVID-19. Do not share your HIV meds with anyone who thinks it might help with COVID-19. Some people have harmed themselves or died because they have misunderstood or been told that certain drugs could help in illness prevention when this is not the case. Prepster have a detailed page on this topic. We agree with them that it is strongly discouraged to start using PrEP or HIV treatments as COVID-19 prevention. If you decide to start or continue taking PrEP on the basis of possible COVID-19 prevention, it’s strongly advised that you DO NOT take more than the recommended dosing as you normally would. You've probably heard about a number of trials around the world in which HIV treatments are being used to see if they have benefit to people with COVID-19. These trials are still ongoing, with some having to be paused, and so there is currently no evidence that HIV treatments have any effect on COVID-19, as either treatment or prevention. BHIVA has some useful information on this topic, with the main takeaway being that the first randomised clinical trial with lopinavir/ritonavir (commonly part of HIV antiretroviral treatment) demonstrated no benefit over standard care in 199 hospitalised adults with severe COVID-19. There is no evidence to support the use of other antiretrovirals.