Individuals living with HIV can safely be vaccinated against COVID-19. As part of the authorization process that the available vaccines go through before being available for mass vaccination, clinical trials allow researchers to establish the safety of a vaccine. The clinical trials used to test the safety of the authorized Covid-19 vaccines included people with HIV infection, and were deemed safe. 

For people diagnosed with HIV, regular treatment can keep immune systems healthy. There is no evidence that the authorized vaccines interfere with the effect of medical treatment for HIV. Vaccines are recommended for everyone with HIV, regardless of their disease stage, and strength of their immune system. 

Currently, there is no evidence that HIV treatment can help prevent or treat COVID-19 infections.

Some additional steps that can help prevent a COVID-19 infection apply to individuals with and without HIV:

• Get vaccinated if you are eligible
• Wear a mask that covers your nose and mouth 
• Maintain social distancing (six feet apart from others) 
• Avoid crowded and poorly ventilated areas
• Wash your hands regularly with soap and water, and use hand sanitizer when washing is not available 

Experts also advise people with HIV to:

• Follow up with their doctors regularly, and safely, by taking COVID-19 precautions at the clinic or using remote consultations (Telemedicine), and medication delivery services if available 
• Make sure they have a 30 to 90 day supply of HIV medication, and any other medication needed to maintain their health
• Making sure they are up to date on other vaccines such as the seasonal flu and bacterial pneumonia as people with HIV are at a higher risk of these infections 

People who have a weakened immune system as a result of advanced or untreated HIV may not be fully protected, even if they are vaccinated. They should continue to protect themselves the same way unvaccinated people would, and follow up with their doctor. The U.S. Centers for Disease Control suggest additional doses of the Pfizer-BioNTech or Moderna COVID-19 vaccine, taken within 28 days of the second dose, for people with advanced or untreated HIV. The same recommendation was not made for the Johnson & Johnson’s Janssen (J&J/Janssen) COVID-19 vaccine as there was not enough scientific evidence to suggest a benefit from an additional dose.

Everyone with HIV benefits from maintaining a healthy diet, sleeping at least 8 hours a day, reducing stress as much as possible and getting regular medical treatment for HIV. They should also maintain an emergency contact in case they get sick.

People living with HIV infections who are not taking medical treatment generally have a weaker immune system than people with HIV on regular treatment and people without HIV. For this reason, they are at higher risk of some infections, which can affect them more than people without HIV. These can often be the cause of death in advanced HIV patients. However, there is no clear evidence that having HIV increases the chances of someone getting infected with COVID-19 and/or developing serious complications from the disease. 

People with HIV sometimes have other medical conditions along with the infection, such as high blood pressure, heart disease, and lung disease. Individuals with these conditions, regardless of their HIV status, have been found to have more severe COVID-19 infections, develop complications and are more likely to be hospitalized. Some studies are starting to show a mild increase in risk for individuals with HIV for developing complications, and although these studies are not yet conclusive, it highlights the urgency of caring for people with HIV. This includes making sure they have access to safe care, adequate supply of medications (for HIV and other conditions) and food to maintain a healthy and strong body. 

This can be particularly challenging for some populations. The HIV pandemic does not affect all populations equally. In 2020, 55 per cent of global HIV cases were reported in eastern and southern Africa. Only six per cent were in Western and Central Europe and North America. In the United States the black and hispanic population, which accounts for 31% of the country, represents 64% of HIV cases. 

During the pandemic, lockdowns, recent unemployment, lack of income or medical insurance, a lack of knowledge of or access to patient assistance programs have become additional barriers to getting treatment. Additionally, COVID-19 disrupted some channels by which these populations get access to treatment through community-based organizations, and primary care. 

HIV in the time of the pandemic is a complex public health issue that requires regular access to care, community support, outreach and education to protect the vulnerable population of people living with HIV.