COVID-19

Rights in the time of COVID-19

Lessons from HIV for an effective,
community-led response.

Seven takeaways:

COMMUNITIES ARE CENTRAL

Engage affected communities from the beginning in ALL response measures—to build trust, ensure suitability and effectiveness, and to avoid indirect or unintended harms and ensure the frequent sharing of information.

NO STIGMA AND DISCRIMINATION

Combat all forms of stigma and discrimination, including those based on race, social contacts, profession (healthcare workers), and those directed towards marginalized groups that prevent them from accessing care.

SUPPORT THE MOST VULNERABLE

Ensure access to free or affordable screening, testing and care for the most vulnerable and hard to reach.

REMOVE BARRIERS TO ACTION

Remove barriers to people protecting their own health and that of their communities: fear of unemployment, healthcare costs, presence of fake news/misinformation, lack of sanitation infrastructure and so forth.

NO CRIMINAL SANCTIONS

Restrictions to protect public health must be of limited duration, proportionate, necessary and evidence-based and reviewable by a court. Put in place exceptions where necessary for vulnerable groups and to ameliorate the consequences of such restrictions. Blanket compulsory bans are rarely effective or necessary. Individuals should not be criminalized for breaching restrictions.

INTERNATIONAL COOPERATION

Countries must work to support each other to ensure no country is left behind, sharing information, knowledge, resources and technical expertise.

BE KIND

Support and protect health care workers. Be kind to each other. Join and support efforts that build trust and amplify solidarity, not sanctions.

What people living with HIV need to know
about HIV and COVID-19

COVID-19 is a serious disease and all people living with HIV should take all recommended preventive measures to minimize exposure to, and prevent infection by, the virus that causes COVID-19.

As in the general population, older people living with HIV or people living with HIV with heart or lung problems may be at a higher risk of becoming infected with the virus and of suffering more serious symptoms.

We will actively learn more about how HIV and COVID-19 together impact on people living with HIV from countries and communities responding to both epidemics. Lessons in rolling out innovations or adapting service delivery to minimize the impact on people living with HIV will be shared and replicated as they become available. Until more is known, people living with HIV—especially those with advanced or poorly controlled HIV disease—should be cautious and pay attention to the prevention measures and recommendations. It is also important that people living with HIV have multimonth refills of their HIV medicines.

Precautions that people living with HIV and key populations should follow to prevent COVID-19 infection

Stay safe

Clean hands frequently with soap and water (for 40–60 seconds) or an alcohol-based hand sanitizer (for 20–30 seconds).
Cover your mouth and nose with a flexed elbow or tissue when coughing or sneezing. Throw the tissue away after use.
Avoid close contact with anyone who has a fever or cough.
Stay home when you are ill.
If you are experiencing fever, a cough and difficulty breathing and have recently travelled to, or are a resident in, an area where COVID-19 is reported, you should seek medical care immediately from your community health service, doctor or local hospital. Before you go to a doctor’s office or hospital, call ahead and tell them about your symptoms and recent travel.
If you are ill, wear a medical mask and stay away from others.

Stay informed

Know the facts about COVID-19 and always check a reliable source, such as the World Health Organization: https://www.who.int/emergencies/diseases/novel-coronavirus-2019.

Be prepared

You should have a supply of your necessary medical supplies on hand—ideally for 30 days or more. The World Health Organization HIV treatment guidelines now recommend multimonth dispensing of three months or more of HIV medicines for most people at routine visits, although this has not been widely implemented in all countries.
Know how to contact your clinic by telephone in the event that you need advice.

Know how to access treatment and other supports within your community. This treatment could include antiretroviral therapy, tuberculosis medication (if on tuberculosis treatment) and any other medication for other illnesses that you may have.
Key populations, including people who use drugs, sex workers, gay men and other men who have sexwith men, transgender people and prisoners, should ensure that they have essential means to prevent HIV infection, such as sterile needles and syringes and/or opioid substitution therapy, condoms and pre-exposure prophylaxis (PrEP). Adequate supplies of other medications, such as contraception and gender-affirming hormone therapy, should also be obtained.

Not all countries have implemented policies to allow for longer prescriptions. Be in touch with your health-care provider as early as possible. Consider working with others in your community to persuade health-care providers and decision-makers to provide multi-month prescriptions for your essential medicines.
Discuss with your network of family and friends how to support each other in the event that social distancing measures are put in place. Make alternate arrangements within your community for food, medicines, care for children or pets, etc.
Help others in your community and ensure that they also have an adequate supply of essential medicines.
Check that you know how to reach your local network of people living with HIV by electronic means. Make a plan for telephone and for social media connections in the event that public health measures call for people to stay home or if you become ill.

Support yourself and people around you

The outbreak of COVID-19 may cause fear and anxiety—everyone is encouraged to take care of themselves and to connect with loved ones. People living with HIV and their communities have decades of experience of resilience, surviving and thriving, and can draw on their rich shared history to support their families and communities in this current crisis. Pay particular attention to your mental health by:

Avoiding excessive exposure to media coverage of COVID-19. Only read information from trusted sources.
Taking care of your body. Take deep breaths, stretch or meditate. Try to eat healthy, well-balanced meals, exercise regularly, get plenty of sleep and, where possible, avoid alcohol and drugs.

Making time to unwind and reminding yourself that negative feelings will fade. Take breaks from watching, reading or listening to news stories—it can be upsetting to hear about the crisis repeatedly. Try to do some other activities you enjoy in order to return to your normal life.

Connecting with others. Share your concerns and how you are feeling with a friend or family member.

Stop stigma and know your rights

Stigma and discrimination is a barrier to an effective response to COVID-19. This is a time where racism, stigma and discrimination can be directed against groups considered to be affected.

Your workplace, access to health care or access to education, for you or your children, may be affected by the COVID-19 outbreak if social distancing measures are put in place in your community. Find out your rights and make sure that you and your community are prepared.

Treatment of COVID-19

Treatment of COVID-19 is an active area of research and several randomized clinical trials are ongoing to determine whether antiretroviral medicines used for treating HIV might be useful for treating COVID-19. Many other possible treatments are also being tested in well-designed clinical trials.
Since those trials have not ended, it is too early to say whether antiretroviral medicines or other medicines are effective in treating COVID-19. A recent clinical trial showed that there was no substantial benefit of using Kaletra to treat COVID-19.