COVID-19 & HIV - FAQs

INFORMATION PUBLISHED BY BHIVA 19 MARCH 2020

Coronaviruses (CoV) are a large family of viruses that can infect mammals and birds. Seven strains can infect humans, typically causing mild illness (1 in 6 cases of the common cold are caused by coronaviruses) and more rarely serious illness.

 

There are currently no coronavirus vaccines or antiviral drugs but research teams across the globe are working tirelessly to change that. There have been headlines about using the HIV drug lopinavir/ritonavir (uncommonly used for treatment in the UK) to treat coronavirus but no good evidence yet that it will work. The drugs used for PrEP are not active against coronavirus.

 

COVID-19 is a new condition caused by the SARS-CoV-2 strain of the coronavirus, which spreads very easily from person-to-person (much more so than some other types of coronavirus). Nobody has existing immunity to it. Although the estimated death rate of about 1 in 100 people sounds low compared to some infections, if very large numbers of people are infected that would result in a high number of deaths. Current data suggests that 1 in 5 people develop more severe illness, and large numbers needing hospital treatment could rapidly overwhelm health care systems - this is happening in Italy now. People most at risk of serious illness and death are the elderly and people with long-term medical conditions such as lung disease, kidney disease and diabetes.

 

However, about 80% of people with COVID-19 have relatively mild illness, which can lead to diagnosis of infection being delayed or missed altogether, which increases the risk of passing the virus on. Data from Japan estimates 1 in 3 people with COVID-19 have no symptoms – making control even harder.

 

In February the World Health Organisation (WHO) declared COVID-19 a 'Public Health Emergency of International Concern' – giving WHO the legal right to make recommendations about dealing with it and (hopefully) stimulating funding and Government action. On 11th March 2020 WHO declared COVID-19 a pandemic, which is an epidemic that has spread over several countries or continents, usually affecting large numbers of people.

 

BHIVA have issued answers to the most frequently asked questions.

Thursday, 19 March, 2020

 

ATTENTION: UPDATED 25th MARCH

 

The British HIV Association (BHIVA) updated a statement on the virus and HIV on the 25th March. You can read the statement on the BHIVA website – www.bhiva.org

 

The latest updates include

 

BHIVA statement on management of a pregnant woman living with HIV and infant testing during Coronavirus (COVID-19)

 

British HIV Association (BHIVA) and Terrence Higgins Trust (THT) statement on COVID-19 and advice for the extremely vulnerable

 

Wednesday, 18 March, 2020

 

CORONAVIRUS: IMPACT ON OUR SERVICES

 

UPDATED 18 MARCH 2020

 

Due to the ongoing situation with regards to the coronavirus outbreak the George House Trust building will be closed with effect from Friday March 20th until further notice.

 

We are taking this course of action reluctantly - but we hope that you will agree that, in the circumstances, it is the most sensible thing to do.

 

This means that we need to make changes to working arrangements which will have a significant impact on the services we can provide.

 

Staff will be working from home and will be able to provide one to one support by phone. Similarly, our volunteer peer mentors will provide telephone support and the programme remains open for referrals.

 

From 9am on Friday March 20th, if you are in need of support, advice or information and would like to speak to someone please email talk@ght.org.uk and include your telephone number in your message and we will call you back.

 

We cannot provide the following services until further notice:

 

  • Group events
  • Counselling
  • Volunteer Driving
  • Manchester City Council Welfare Rights appointments
  • Welfare Fund applications

 

Arrangements are also in place to continue to provide:

 

  • Formula Milk
  • Support for people who are destitute

 

We are keeping up to date with any new information about coronavirus and HIV which we will publish on the George House Trust website www.ght.org.uk and our social media platforms.

 

We want to assure you that we will continue to provide the very best services we possibly can in these challenging circumstances – but we also need to be clear that the same levels of support we normally provide simply won’t be possible at this time.

 

We are keeping the situation under constant review and we will update this page when there are any planned changes to these arrangements.

 

We look forward to being able to resume normal service again soon.

Wednesday, 18 March, 2020

Comment from the British HIV Association (BHIVA) and the Terrence Higgins Trust (THT) on UK Government Guidance on Social Distancing to Protect Vulnerable Adults, published 16 March 2020

 

Tuesday 17 March 2020

 

The British HIV Association (BHIVA) and the Terrence Higgins Trust (THT) have received a number of enquiries about the UK Government's Guidance that "members of the public with serious health conditions will soon be asked to self-isolate for 12 weeks." This is defined in the Guidance as "anyone instructed to get a flu jab as an adult each year on medical grounds" which includes anyone living with HIV.

 

Whilst there is no evidence so far to determine whether people with HIV are at greater risk of COVID-19 acquisition or severe disease the new advice reflects the lack of evidence by classifying all people with HIV as vulnerable.

 

The Guidance from Public Health England (PHE) on Social Distancing for Vulnerable Groups, including people with HIV is available here: https://www.gov.uk/government/publications/covid-19-guidance-on-social-distancing-and-for-vulnerable-people/guidance-on-social-distancing-for-everyone-in-the-uk-and-protecting-older-people-and-vulnerable-adults. The general advice in this does not go as far as to recommend self-isolation for all at risk, nor does it specify a duration of time for the self-isolation.

 

More detail is expected soon and this may include specific advice for people living with HIV based on viral load and CD4 count, as people on HIV treatment with a good CD4 and undetectable viral load are not usually considered to have a "weakened immune system" as specified in the PHE guidance. BHIVA and THT will aim to inform the HIV community about new developments in the field as they emerge but right now we recommend following PHE’s "social distancing" advice which does not necessarily mean "self-isolation."

 

For further information, please contact Jo Josh on +44 (0) 7787 530922 or jo@commsbiz.com

 

Read online

 

 

Tuesday, 17 March, 2020

What will help you live confidently with HIV?

 

We are in the process of finalizing our calendar of sessions, courses and events for the next year. We want to run information and advice sessions that are relevant and important to you, and help you to live confidently with HIV.

 

We have previously held talks on HIV treatment, ageing with HIV and HIV and the law.

 

We want to hear your ideas on what you would like us to cover this year.

 

You can send your ideas to Josh or call 0161 274 4499.

Monday, 16 March, 2020

 

FREE FORMULA MILK PROVISION FOR BABIES BORN TO WOMEN WHO ARE LIVING WITH HIV AND RESIDENT IN THE CITY OF SALFORD

 

Are you a woman living with HIV and a resident of Salford?

 

Do you have a child who is under 12 months old?

 

Are you pregnant?

 

Do you know that breastfeeding is an identified route of vertical transmission of HIV, and current UK clinical guidance recommends that an infant born to a mother living with HIV is fed exclusively with formula milk?

 

George House Trust administers a Formula Milk Scheme funded by Salford City Council and open to residents of Salford borough.

 

The scheme provides free formula milk for the first 12 months of the baby’s life, and a starter steriliser kit to women living with HIV who give birth and is open to all women regardless of income or immigration status.

 

Referrals to the scheme

Pregnant women living with HIV or mothers living with HIV with infants under 12 months old who are resident in Salford can be referred to George House Trust via the ‘make a referral’ section of our website.

 

Referrals can be made by any health professional or people may self-refer.

 

To find out more about the scheme contact adela@ght.org.uk or call 0161 274 4499

Wednesday, 1 January, 2020

NEW ROLE, NEW YOU - VOLUNTEER ROLES

 

NEW ROLE, NEW YOU

 

The new Distribution Volunteer role is an ideal addition to your current volunteer responsibilities and would be perfect for volunteers living outside of Manchester City Centre. Our Distribution Volunteers will distribute and restock George House Trust informational literature at identified sites across Greater Manchester.

 

You will be able to collect the literature from the office at your convenience and distribute the materials in your local area. This is a very flexible role and will be integral to ensuring people in your local area know about George House Trust and how to access services.

 

You can check out the role description here

 

If you fancy something a little more office based then why not think about supporting us as a Finance Administration Volunteer? This role is ideal for someone looking to volunteer for four hours per week to either gain or build skills in financial and accounting procedures. This role is suitable for anyone with an interest in finance and would provide a good insight into how a small charity works.

 

You can check out the role description here

 

If either of those roles appeal to you then please drop me an email or give me a call and we can discuss them in more detail.

Wednesday, 22 January, 2020

PEOPLE WITH HIV AND THEIR DOCTORS HAVE DIFFERENT PRIORITIES FOR CLINICAL CARE

When patients living with HIV were asked to rank the priority issues to be covered during a routine clinical appointment, they ranked social issues such as stigma and social support far higher than their healthcare providers, who often wanted to focus on substance use. The study by Dr Rob Fredericksen of the University of Washington is published online by AIDS and Behavior.

 

A total of 206 patients were recruited at five clinics in Birmingham, Alabama; San Diego, California; San Francisco, California; Boston, Massachusetts; Seattle, Washington. Efforts were made to recruit a diverse sample, including cisgender women (30%), transgender women (9%), people aged under 30 (11%) or over 55 (22%), black (33%) and Latino people (28%), individuals poorly engaged in care (25%), people with a detectable viral load (29%), people diagnosed in the past five years (30%) and rural residents (10%).

 

They were given a list of 25 possible issues to address in a typical clinical visit and asked to select their top eight priority issues as well as the three least important topics.

 

Separately, 17 healthcare providers completed the same exercise.

 

The top issues for people living with HIV were:

  1. Medication adherence
  2. HIV and treatment symptoms
  3. Depression
  4. Sexual risk behaviour
  5. HIV stigma
  6. Pain
  7. Physical function
  8. Social support.

 

Their three lowest priorities were anger, shortness of breath, and tobacco use.

 

Healthcare providers’ priorities were different:

  1. Substance abuse
  2. Depression
  3. Medication adherence
  4. Alcohol abuse
  5. Tobacco use
  6. Sexual risk behaviour
  7. HIV and treatment symptoms
  8. Cognitive function.

 

Clinicians ranked shortness of breath, positive affect, and spirituality/meaning of life as the least important.

 

Whereas 94% of clinicians put substance abuse in their top eight, only 36% of patients did so. Similarly, 71% of clinicians put tobacco use in their top eight, compared to 15% of patients, and this was the lowest overall ranked item for people living with HIV.

 

People living with HIV tended to rate social issues such as HIV stigma and social support as of greater importance than healthcare providers did. For example, 48% of patients and 18% of clinicians included stigma in their list of top eight issues. People who had been diagnosed with HIV more recently, were younger, were black or Latino and were more likely to see stigma as a priority issue.

 

A number of symptoms and social issues were considered a priority by significant numbers of patients but not by a single healthcare provider who took part: positive affect (31% of patients), fatigue (27%), spirituality/meaning of life (26%), sleep disturbance (22%), social roles (18%), social isolation (17%) and anger (16%).

 

Qualitative interviews in which 79 patients explained their choices showed that they saw social issues and health behaviours as being closely interconnected, as this man explained:

“If you don’t get over the stigma… none of this matters. The isolation is gonna come in, right? You’re not gonna even care about the symptoms or the treatments. You’re not gonna take care of your medication, you’re gonna start that risky behaviour.”

 

Drug use and sexual risk behaviours were often described as self medication in response to stigma and social isolation.

“[HIV stigma] is all you think of… It causes depression and then you want to use [drugs]. You’re gonna socially isolate yourself, because you don’t want to deal with people like that.”

 

People who had been living with HIV for several years talked about how their priorities had changed over time. Some issues had been particularly important soon after diagnosis:

“Now, the reason why I have them in this order is because when I first found out about me being diagnosed, these first three [depression, HIV stigma, spirituality/meaning of life] it hit me hard. I was depressed. I didn’t want to be around… I didn’t know how to handle it at first.”

 

When asked how they would like healthcare providers to address issues like stigma and social isolation, many people with HIV acknowledged that there may be no ‘easy fix’ to these complex issues. However, they expressed deep appreciation of clinicians who acknowledged difficult circumstances in their lives.

 

The interviews suggested that showing interest, demonstrating familiarity with the issues, and making appropriate referrals to mental health and social support services may often be sufficient.

 

“Many patients felt it important that their healthcare address the at-times overwhelming context-based problems in their lives,” Fredericksen and colleagues note. Doing so may strengthen the doctor-patient relationship and so improve the likelihood of successfully addressing other issues, they suggest.

Thursday, 2 January, 2020

 

VOLUNTEER THANK YOU AWARDS EVENT

 

Although it is still some time away yet we are starting to get our thinking caps on about the next volunteer social.  We will be celebrating National Volunteers Week in June and want to show our appreciation to the volunteer team by hosting a thank you awards ceremony.

 

It would be great to hear from you if you have a suggestion of a venue we could host it in this year? Answers on a postcard to Rachel.

Tuesday, 21 January, 2020

MEMBERS MEETING - FEBRUARY 5th 2020

 

MEMBERS MEETING - FEBRUARY 2020

 

Our next Members Meeting is coming up on Wednesday, February 5th.  Members will receive an invitation to this meeting from Ingrid, our Governance Administrator.

 

Not a member yet? Please visit our Membership Area for further information.

Monday, 20 January, 2020

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