Coronavirus disease (COVID-19), HIV & hepatitis C: What you need to know

CATIE (Canada), 17 March 2020

  • An HIV-positive person on effective treatment is not expected to be at higher risk of becoming seriously ill with COVID-19
  • A person with untreated HIV or a low CD4+ cell count may be at higher risk of becoming seriously ill with COVID-19
  • People with HIV or hepatitis C are more likely to have other conditions that carry a greater risk of becoming seriously ill with COVID-19

 

 

Update on COVID-19 for PLHIV

SAMESH, March 19, 2020

SAMESH, SHINE SA, and Thorne Harbour Health are encouraging people living with HIV (PLHIV) to take additional precautions in the face of the changing landscape around 2019 novel coronavirus (COVID-19).

We want to ensure the ongoing health and wellbeing of all PLHIV who are more vulnerable to COVID-19. This means minimising the risk of exposure to the virus.

While everyone is at risk of contracting COVID-19, the consequences of infection are more severe for some vulnerable groups. This includes PLHIV who are:

  • Aged over 60 years old
  • Living with a detectable viral load or a CD4 count below 500
  • Diabetic
  • Smokers
  • Living with hepatitis B or C
  • Living with a comorbidity such as heart or lung issues

Those PLHIV on treatment with an undetectable viral load (and no other significant health condition) are at no greater risk of serious health consequences due to COVID-19 than the general population. That being said, they should still take the advice of the health department in exercising precautions such as handwashing, working from home where possible, limiting time on public transport, and avoiding large groups or crowded areas.

Those PLHIV who fall into one of the vulnerable groups listed above should limit contact with others to avoid potential exposure to COVID-19.

If you are living with HIV and are concerned you might be at risk, you should:

  • Maintain regularly scheduled medical appointments, but consider asking your doctor about telehealth consultations
  • Ensure you have between 1-3 month supply of any medications you currently take
  • Avoid stockpiling medications beyond a 1-3 month supply as this could cause unnecessary shortages
  • Be wary of advice or articles in social media — do not modify the medications you currently take without first consulting your doctor
  • Contact your doctor about getting vaccinations for influenza and pneumococcal when available
  • Keep in touch with friends, colleagues, and family via phone calls and video chat — consider scheduling regular catch ups
  • Stay in touch – our organisations will continue to release more information and resources as the situation continues to evolve

This public health issue can be stressful, but our communities have a long history of staying informed and collective action to ensure we look after our health as well as the wellbeing of those around us. Let’s keep this legacy going as we look after ourselves and those around us

Delayed linkage to HIV care among asylum seekers

Kronfli, N., Linthwaite, B., Sheehan, N. et al. Delayed linkage to HIV care among asylum seekers in Quebec, CanadaBMC Public Health 191683 (2019). https://doi.org/10.1186/s12889-019-8052-y

Abstract:

Background

Migrants represent an increasing proportion of people living with HIV in many developed countries. We aimed to describe the HIV care cascade and baseline genotypic resistance for newly diagnosed asylum seekers referred to the McGill University Health Centre (MUHC) in Montreal, Quebec, Canada.

Methods

We conducted a retrospective cohort study of patients linked to the MUHC from June 1, 2017 to October 31, 2018. We calculated the median time (days; interquartile range (IQR)) from: 1) entry into Canada to immigration medical examination (IME) (i.e. HIV screening); 2) IME to patient notification of diagnosis; 3) notification to linkage to HIV care (defined as a CD4 or viral load (VL) measure); 4) linkage to HIV care to combination antiretroviral therapy (cART) prescription; and 5) cART prescription to viral suppression (defined as a VL < 20 copies/mL). We reviewed baseline genotypes and interpreted mutations using the Stanford University HIV Drug Resistance Database. We calculated the proportion with full resistance to > 1 antiretroviral.

Results

Overall, 43% (60/139) of asylum seekers were newly diagnosed in Canada. Among these, 62% were late presenters (CD4 < 350 cells/μl), 22% presented with advanced HIV (CD4 < 200 cells/μl), and 25% with high-level viremia (VL > 100,000 copies/ml). Median time from entry to IME: 27 days [IQR:13;55]; IME to notification: 28 days [IQR:21;49]; notification to linkage: 6 days [IQR:2;19]; linkage to cART prescription: 11 days [IQR:6;17]; and cART to viral suppression: 42 days [IQR:31;88]; 45% were linked to HIV care within 30 days. One-fifth (21%) had baseline resistance to at least one antiretroviral agent; the K103 N/S mutation was the most common mutation.

Conclusions

While the majority of newly diagnosed asylum seekers were late presenters, only 45% were linked to care within 30 days. Once linked, care and viral suppression were rapid. Delays in screening and linkage to care present increased risk for onward transmission, and in the context of 21% baseline resistance, consideration of point-of-care testing and immediate referral at IME screening should be made.

Multilingual booklet in 8 languages – HIV: What you need to know

Multicultural HIV and Hepatitis Service, NSW, 2019

The new multilingual booklet, HIV. What you need to know, summarises the most current information on HIV.

It explains what it means to have HIV as well as ways to protect yourself from getting HIV and passing it on to others.

It also explains how to get tested, and how HIV is treated, including a comprehensive list of HIV health care and support services available in NSW.

Information about the Australian health care system, and HIV and legal issues are also provided.

Available in eight languages, the free booklet was developed in consultation with our communities.

  • Click on the language below to download the e-booklet
  • To order free hard copies of the  booklet please complete the order form and email to info@mhahs.org.au

 

English Arabic
Chinese Indonesian
Portuguese Spanish
Thai Vietnamese

U and Me Can Stop HIV (video)

YoungDeadlyFree, December 2019

U and me Can Stop HIV: this 8-minute animated video is designed to reach Aboriginal and Torres Strait Islander people with the latest information on HIV. 

Animations can help explain the facts about STIs and BBVs in an engaging way that’s easy to understand, and not too confronting. YoungDeadlyFree have produced these animations for young people to access directly via social media but they’re also great tools for community education.

As well as setting out the facts about STIs and BBVs, each of these animations aims to normalise STI and BBV testing, and address the stigma and shame we can feel when talking about sex, STIs and BBVs.

  • Watch embedded video below:

High-risk behaviors and their association with awareness of HIV status among participants of a prevention intervention

High-risk behaviors and their association with awareness of HIV status among participants of a large-scale prevention intervention in Athens, Greece.

Pavlopoulou, I.D., Dikalioti, S.K., Gountas, I. et al.

BMC Public Health 20, 105 (2020). https://doi.org/10.1186/s12889-020-8178-y

Abstract

Background

Aristotle was a seek-test-treat intervention during an outbreak of human immunodeficiency virus (HIV) infection among people who inject drugs (PWID) in Athens, Greece that started in 2011. The aims of this analysis were: (1) to study changes of drug injection-related and sexual behaviors over the course of Aristotle; and (2) to compare the likelihood of risky behaviors among PWID who were aware and unaware of their HIV status.

Methods

Aristotle (2012–2013) involved five successive respondent-driven sampling rounds of approximately 1400 PWID each; eligible PWID could participate in multiple rounds. Participants were interviewed using a questionnaire, were tested for HIV, and were classified as HIV-positive aware of their status (AHS), HIV-positive unaware of their status (UHS), and HIV-negative. Piecewise linear generalized estimating equation models were used to regress repeatedly measured binary outcomes (high-risk behaviors) against covariates.

Results

Aristotle recruited 3320 PWID (84.5% males, median age 34.2 years). Overall, 7110 interviews and blood samples were collected. The proportion of HIV-positive first-time participants who were aware of their HIV infection increased from 21.8% in round A to 36.4% in the last round. The odds of dividing drugs at least half of the time in the past 12 months with a syringe someone else had already used fell from round A to B by 90% [Odds Ratio (OR) (95% Confidence Interval-CI): 0.10 (0.04, 0.23)] among AHS and by 63% among UHS [OR (95% CI): 0.37 (0.19, 0.72)]. This drop was significantly larger (p = 0.02) among AHS. There were also decreases in frequency of injection and in receptive syringe sharing in the past 12 months but they were not significantly different between AHS (66 and 47%, respectively) and UHS (63 and 33%, respectively). Condom use increased only among male AHS from round B to the last round [OR (95% CI): 1.24 (1.01, 1.52)].

Conclusions

The prevalence of risky behaviors related to drug injection decreased in the context of Aristotle. Knowledge of HIV infection was associated with safer drug injection-related behaviors among PWID. This highlights the need for comprehensive interventions that scale-up HIV testing and help PWID become aware of their HIV status.