WORLD AIDS DAY OPINION PIECE
KMA Public Health Committee
By Dr. Wairimu Mwaniki
2020 has been a difficult year for the world as a whole. The Coronavirus disease, a respiratory infection caused by the novel COVID-19 virus, has morphed from being a little known about illness to a global pandemic. The effects of the pandemic have spared nobody, particularly vulnerable and key populations. One such demographic includes PLWHIV. Research on COVID-19 and it’s association with HIV is ongoing. At the moment, scientists have more questions than answers on the relationship between the two viruses.
The pandemic has taken a huge toll on global healthcare particularly in low and middle income countries. Economies have taken major blows with many families losing their sources of livelihood. The health sector has not been spared either. The soaring number of COVID-19 patients continues to overwhelm healthcare systems across the globe. Many countries do not have the necessary capacity to manage the COVID-19 pandemic as per stipulated international health guidelines. In addition, the current approach to self-protection, social distancing and isolation has been extremely difficult to sustain. Scarcity in resources channelled towards the management of the disease has begat an overloaded healthcare system that continues to crumble under the pressure of the pandemic. This has translated into poor service delivery to patients, particularly PLWHIV.
The current health crisis analogous to COVID-19 is already affecting health seeking behaviour among PLWHIV. In poor resource set ups, people just do not have enough resources, particularly financial ones, to regularly seek medical attention even when sick . Unfortunately, the COVID-19 pandemic has also challenged the accessibility of antiretroviral treatment (ART) Significant cuts in HIV funding to poorer countries and major breakdowns in the ART supply chains due to importation set backs precipitated by the pandemic are some of the factors that have rendered HIV treatment inaccessible to many.
The COVID-19 pandemic has also taken a major emotional and psychological toll on PLWHIV. The stigma and overall fear associated with the Coronavirus disease is a situation that is all too familiar to PLWHIV. Those who have tested positive for COVID-19 have had to face the effects of double stigma and virus-shaming as a result of the two pandemics. PLWHIV are ailing from COVID-19 in silence for fear of being stigmatised by family and healthcare personnel.
The double stigma being levied on PLWHIV who also get infected with the COVID-19 virus is however unwarranted. PLWHIV who are on ART and have achieved viral suppression are not at an increased risk of suffering from severe COVID-19 infection compared to the general population. However PLWHIV who also suffer from co-morbid conditions like cardiovascular or lung disease may be at a higher risk of becoming infected with the virus and of suffering more serious symptoms. There is currently no evidence to support any protective benefit of antiretroviral therapy to the SARCOV2 virus. However, adhering to antiretroviral therapy has been shown to greatly reduce the risk of severe COVID-19 infection.
In conclusion, robust healthcare systems focusing on prevention, early diagnosis and early initiation of care is key in safeguarding the healthcare of PLWHIV. They must not bear the brunt of increased stigma as a result of the COVID-19 pandemic. We all need to act in empathy and embrace peace, love and unity during these trying times
