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

Discrimination: a health hazard for people from refugee and asylum-seeking backgrounds resettled in Australia

Ziersch, A., Due, C. & Walsh, M. Discrimination: a health hazard for people from refugee and asylum-seeking backgrounds resettled in Australia. BMC Public Health 20108 (2020). https://doi.org/10.1186/s12889-019-8068-3

Abstract

Background

Research has shown that discrimination is harmful to health, but there is relatively little known about discrimination experienced by people from refugee and asylum-seeking backgrounds in resettlement countries and associated health effects. This qualitative-focused mixed methods paper reports on discrimination experienced by refugees and asylum seekers, responses to discrimination, and impacts on health.

Methods

As part of a broader study of housing, social inclusion and health, surveys were completed by 423 adult refugees and asylum seekers living in South Australia who had been in Australia for up to 7 years. The survey included questions on discrimination based on skin colour, ethnicity and religion, as well as questions on hope, trust, belonging, sense of control and health (including the SF-8). Semi-structured interviews were conducted with 65 survey participants, purposively sampled by visa status, continent and gender, further exploring experiences of discrimination. These and survey open-ended responses were analysed thematically.

Results

Twenty-two percent of survey participants reported experiences of discrimination since arriving in Australia (14% in the last year), and 90% of these felt that discrimination had harmed their health. Key settings of discrimination were public transport, within the neighbourhood, and in relation to employment. Those who reported discrimination had significantly worse mental health (p < .000) but not physical health. Discrimination was also associated with less sense of belonging (p = .001), lower levels of trust (p = .038), reduced sense of control (p = .012) and less hope (p = .006). Incidents described in interviews and the open-ended survey responses included incivility, physical assault, and denial of services, experienced across intersecting characteristics of race/ethnicity, religion, gender and visa status. Responses to discrimination spanned affective, cognitive and behavioural dimensions, ranging across types of experience, participant characteristics and context, with most individuals reporting multiple response types. While some of the responses were reported by participants as protective of health, participants’ reflections indicated significant negative impacts on mental health in particular.

Conclusion

Discrimination featured in the resettlement experiences of a significant number of refugees and asylum seekers, with participants reporting clear negative impacts on mental health. Addressing discrimination is a key resettlement and health issue requiring urgent action.