Comment on COVID-19 from the British HIV Association (BHIVA)

posted by: Don Leslie

updated Thursday 16th April 2020

The British HIV Association (BHIVA) and the Terrence Higgins Trust (THT) have updated their 23 March 2020 COVID-19 statement for people with HIV in the light of the latest UK Government advice: https://www.gov.uk/government/publications/full-guidance-on-staying-at-home-and-away-from-others

Everyone is advised to stay at home and:

  • Only go outside for food, health reasons or work (where this absolutely cannot be done from home);
  • Stay 2 metres (6 feet) away from other people;
  • Wash your hands as soon as you get home.

The guidance includes how to reduce risk if you must go outside.

There is separate guidance for people or households who are isolating and ‘shielding’ for people with conditions considered extremely vulnerable, which does not include HIV.

Although there remains no evidence to determine whether people with HIV are at greater risk of getting COVID-19 or severe disease, BHIVA and THT advise that people with a CD4 less than 50, or who have had an opportunistic illness (a serious illness due to suppression of the immune system) within the last 6 months, should be encouraged to follow the shielding advice for the extremely vulnerable.

1) People with a CD4 count <50 or opportunistic illness in last 6 months: follow shielding advice for extremely vulnerable;

2) People with CD4 <200, detectable viral load or not on ART: follow social distancing advice stringently;

3) People with CD4 >200 and undetectable on ART: follow general population advice (ie social distancing).

BHIVA are aware that some people living with HIV have been contacted by letter or text message instructing them to shield. HIV specific advice is still based on your CD4 count and treatment adherence as above. You may be asked to shield because of other health conditions and these can be discussed with us or your GP practice.

Please note that there is no evidence to date that antiretrovirals, as HIV treatment or as PrEP, have any potential for treating coronavirus.

To check the most up-to-date advice please review the BHIVA news pages.

Here is a blog post from THT Medical Director Dr Michael Brady which covers some FAQs: https://www.tht.org.uk/news/coronavirus-covid-19?mc_cid=ddd48f5cfc&mc_eid=1123d39017

If you are concerned please contact  your nearest Devon sexual health clinic for advice.

BHIVA COVID

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Accessing our service during the COVID pandemic

How to access our service:

We have now implemented a telephone triage system for all of our clinics. This system will be in place for the duration of the pandemic. Please contact our services to access this triage system. Our central telephone number is 0300 303 3989.

If you are experiencing symptoms of Coronavirus please do not attend the clinic. Clear advice for people with symptoms of coronavirus is available at nhs.uk/coronavirus .

Advice from our service:

We have updated information on the provision of routine contraception during this pandemic here.

We are currently prioritising these groups for coil and implant (LARC) fits:

  • Those with vulnerabilities including but not limited to those who are: <18, attending abortion and maternity services, homeless, sex workers, victims of sexual assault, people with language barriers, drug and alcohol problems, learning disability, serious mental illness
  • Those aged <30 years

More details on LARC fittings at our service are found here

There is also specific advice on coronavirus available for People Living with HIV here, and for pregnant women here

Self-requested Sexual Health screening by post is available for for under 25s only - more info here

For others with testing requirements please contact the service on 0300 303 3989.

Information is now also available to advise on sexual contact during a time of social distancing here.

Alternative provision:

Please be aware that we may have to cancel, rearrange or shut clinical services in response to changing clinical and staffing pressures created by the Coronavirus pandemic. 

If you are struggling to access sexual health services, alternatives may be available:

  • Emergency Contraception - at your local pharmacy - more info
  • Contraceptive pills and LARC procedures - obtained from your GP
  • HIV postal testing - available to at-risk groups for a small fee -  more info
  • HIV PEPSE - available via A+E departments - more info
  • Condoms by post (for gay and bisexual men only) - more info