Covid-19 will further burden people living with HIV

By Gibson Mhaka,

Bulawayo, 30 April : For a Bulawayo man, Edson Moyo* (44), who has been living with HIV since 2000 and tragically lost his wife three years ago from the same dreaded virus, the outbreak of the novel coronavirus disease (Covid-19) pandemic, is now like a bad memory which has come back to haunt him, as he find himself among the most at risk once again.

To Moyo who is also asthmatic, the coronavirus pandemic’s woes of loneliness, panic, and fear of being vulnerable to infection are searingly evocative of the early years when he was diagnosed with HIV and subsequently suffered stigma and discrimination based on his HIV status.

Recounting the days, he lost his wife, Moyo, recalled being shunned by neighbours, workmates and even by his relatives, who were refusing to visit his house.

“The Covid-19 pandemic is terrifying for many of us, who are HIV positive. It feels so distressingly familiar and it bringing up a lot of emotions for me who lived through the early years of HIV and Aids when I suffered stigma and discrimination based on my HIV status.

“When the country recorded its first Covid-19 death, I told myself that those days are back. It was even more terrifying after reports that the victim had an underlying condition,” said a distraught Moyo.

But his sadness has not ended there.

“I’m living in fear of this deadly virus. I have been thinking about it a lot, that if I contracted it, I will certainly die,” he added, referring to the coronavirus disease pandemic that has so far killed thousands of people across the globe.

Moyo is among the high-risk and vulnerable population in the Southern African Development Community (SADC) region who have specific underlying conditions such as HIV and apparently calling for greater assistance amid the deadly coronavirus pandemic where discrimination can create barriers to accessing prevention, testing and treatment services and put their lives at risk.

There is no doubt that Covid-19 patients can also definitely feel this stigmatisation. And because of that fear people with suspected coronavirus are being made to feel guilty about this viral disease.

According to a report by Avert, an international organisation that is working at the forefront of HIV and sexual health education as of October last year, East and Southern Africa is the region hardest hit by HIV in the World. It is home to around 6.2% of the world’s population of the total number of people living with HIV in the world (20.6 million people).

Although, the World Health Organisation (WHO) said there is no evidence to date that the risk of infection or complications of Covid-19 is different among people living with HIV who are clinically and immunologically stable on antiretroviral treatment compared with the general population, Moyo’s hope of surviving muted when Centers for Disease Control and Prevention (CDC) highlighted people with underlying health conditions, such as HIV are suspected to have a higher risk of severe illness from Cvovid-19.

Studies have also shown that those with advanced HIV, low count of infection-fighting CD4 cells, or who are not taking or have no access to antiretroviral treatment may have an increased risk of infections and health complications related to Covid-19.

Investigations have also established that although, hospitals have separate departments for coronavirus patients, some people living with HIV are even afraid of going to hospitals to get their medication out of fear they could be exposed to the coronavirus.

“I am afraid to go to the hospital to get my medication for fear of contracting coronavirus. I am thinking I will be exposed by just entering the hospital,” said another HIV patient who preferred to be called Mary.

To allay Moyo and Mary’s fears, people living with HIV should ensure that they continue to safely access their medication. This also demands Governments to establish alternative multi-month dispensing centers for them so as to reduce hospital visits where they will be at risk of suffering devastating losses from Covid-19.

According to AIDSinfo, a federal resource of HIV-related information, some people with HIV have other comorbidities (e.g., cardiovascular disease or lung disease) that increase the risk for a more severe course of Covid-19 illness.

The study warned that, until more is known, additional caution for all persons with HIV, especially those with advanced HIV or poorly controlled HIV, is warranted.

The warning calls for the need by Governments to develop additional dedicated services to people living with HIV or other vulnerable groups, by providing protective equipment which can assist them in maintaining precautionary hygiene, and making sure they become more alert on the seriousness of a potential infection.

It is important to note that as countries continue to battle the pandemic, people with HIV deserve to be reassured that their survival is a priority. This is because they feel they have been left behind.

As a panacea, Zimbabwe Aids Network (ZAN) National Coordinator,Taurai Nyandoro said NGOs and international agencies should sternly advocate that governments adhere to WHO guidelines of multimonth dispensing of HIV treatment.

“As Zimbabwe Aids Network, we have written to the Ministry of Health and Child Care so that they can accelerate the implementation of WHO guidelines like switching to multimonth dispensing whereby HIV patients will be provided with at least three to six months’ supplies of their drugs.

“This will prevent them from running out of medication and the travel restrictions would also reduce their exposure to Covid-19, said Nyandoro.

He said they were also assessing the impact of lockdown on how it disrupts access to treatment, testing, and supply chains.

“After the initial assessment we discovered that a number of our clients are missing appointments due to travel restrictions. As we were also assessing the impact of Covid-19 in terms of mental health and nutrition we also found out that many people living with HIV are worried that they are more at risk of contracting the Corona virus. To help them we have also strengthened the role of churches to provide them with care and support,” said Nyandoro.

He also suggested that to reduce the risk of contracting and death from Covid-19 people with HIV should be allowed to work from home, or be granted paid leave, to guarantee their income security.

National Aids Council (NAC) Bulawayo Provincial Manager, Sinatra Nyathi, concurred with  Nyandoro saying while it’s currently unclear whether HIV-positive individuals are more at risk for contracting the coronavirus, she feared that the pandemic is disrupting or complicating access to treatment.

“We are saying Covid-19 is affecting all people but those who have underlying health conditions such as HIV, their immune system is compromised. They should avoid contracting the virus by doing the following: practising of personal hygiene, social distancing, washing of hands regularly with soap and running water, avoiding touching nose and mouth as well as avoiding of crowds since they are key in combating the spread of the coronavirus.

“They should also make sure that they have their drugs all the time so that they should not miss their medication. If they face any challenges, they should approach us,” urged Nyathi.

She warned that interruptions to antiretroviral therapy (ART) can have dangerous consequences — especially amid a pandemic.

Access to additional financial aid is also vital to reduce the risk of people with HIV and their families falling into greater vulnerability or poverty.

In terms of preparedness, coordination, planning and monitoring, surveillance, case investigation, infection prevention and control, Water, Sanitation and Hygiene (WASH), risk communication and community engagement, as well as, guidance to workplaces and institutions, SADC members states have also adopted WHO guidelines that are critical in responding to the Covid-19 pandemic.

Lessons from HIV for the response to the novel coronavirus

Meanwhile, the HIV pandemic can provide lessons for the response to the Covid-19 pandemic. According to research, no vaccine is available for either and there are no licensed pharmaceuticals for Covid-19, just as there was not for HIV infection in the early years.

Additionally, just, like HIV, coronavirus is not differentiating between poor and rich, no discrimination to race, religion, and ethnicity. The virus is victimising the whole humankind and poses a huge threat to humanity around the globe.

In order to successfully meet the Covid-19 challenge, just like HIV, there is also need to work with local key population groups such as the LGBTI community, sex workers, prisoners and people who use drugs who may be afraid to access health care services because of stigma, discrimination and that ensure that they have access to health care and appropriate services so as to protect them in the face of potential infection.

A health expert,  Senzeni Siziba said as countries take different approaches to control the pandemic, just as they did it for HIV, they must characterise what measures are working in practice, evaluate how people respond, and be alert to unintended effects.

*Not real name.

Gibson Mhaka is a Bulawayo-based reporter with B-Metro which is under the Zimpapers stable and has also undergone a regional training on SRHR courtesy of Gender Links. This story is published as part of Gender Links News Service   Gender and the COVID-19 news series