The world is facing a novel global health crisis with COVID-19. Aviro, as specialists in HIV care, is especially concerned about the COVID-19 outbreak given the HIV prevalence in South Africa. While a lot of work is being done to unpack and understand this global pandemic, Aviro is paying special attention to the measures that need to be considered in a South African context, in an effort to ensure that COVID-19 does not spread rapidly among populations that may be more vulnerable, and to ensure that these populations have sufficient access to care. At the same time, we must make sure to not further stigmatise those living with HIV.

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The South African public health system has limited resources and capacity to respond to such extreme conditions, and one of the worries is that the high HIV prevalence we see here may exacerbate the spread and severity of the disease in our population. The concept of ‘flattening the curve’ means that, although many people may eventually be infected with the virus, infection need not happen at a rapid and uncontrollable pace. Achieving this calls for collective and responsible action to be taken against the virus’ spread, hence social distancing is encouraged. At the same time, we must make sure to find other (electronic) ways to communicate with and support friends and relatives, and encourage others to do so as well, in order to avoid complications around stigma and mental health – issues that those living with HIV may in particular struggle with.

For those with HIV, or working with those with HIV, it is important to implement the standard COVID-19 safety precautions being taken by all as much as possible:

  • Washing hands often with soap and water for at least 20 seconds. If soap and water are not available, an alcohol-based hand sanitiser should be used.
  • Avoid touching eyes, nose, and mouth with unwashed hands.
  • Avoid close contact with people who are sick.
  • Staying home when sick and trying to keep a distance from others at home.
  • Cover your mouth when you cough or sneeze with a flexed elbow or a tissue, then throw the tissue in the bin.
  • Clean and disinfect frequently touched objects and surfaces.

Beyond taking the standard precautions and taking care to not further stigmatise certain populations, is there anything else that can be done for those with HIV? Although the science is still being determined, many in the field believe that a compromised immune system could play a role in how the body responds to the COVID-19 virus. This is why it is important for every person to know their HIV status and start treatment as soon as possible. If someone has been diagnosed as HIV positive, they must continue taking ARV’s (and ensure a good supply is on hand while social distancing remains in effect) or they must restart as soon as possible if they have stopped. This will give their immune system the best chance to respond in the event of a COVID-19 infection.

Aviro believes that understanding the relationship between HIV and COVID-19, and responding appropriately as new evidence becomes available, will be critical to the COVID-19 response in South Africa. We are following developments closely and looking at opportunities to use digital technology to better support patients and providers at the intersection of HIV and COVID-19, as we believe that digital will play a key role in supporting patients and providers in infectious disease pathways. Take care and let’s work together in fighting this virus.