Dr Laura Waters
Chair, British HIV Association (BHIVA)
Since COVID-19 first emerged as a major health threat, the risk of severe illness, death and who was most at risk were major questions. Especially for those living with HIV.
As an organisation, our priorities were to understand the interplay between COVID-19 and HIV, to address uncertainties and anxieties expressed by colleagues and, most importantly, people living with HIV. We have done all we can to share the right information with the right people.
Collaboration with the community
Our approach from the start was to collaborate with community organisations and with HIV and non-HIV bodies and societies. Our first statements, based primarily on first principles and experience with other infections, summarised the scant evidence and who we believed to be at the highest risk of worse outcomes (people with advanced HIV). The impact of immunological and virological markers remains uncertain, though limited data supports our initial beliefs.
Activities since then have included:
- Regular updates to COVID-19 statements covering risk, isolation, shielding, vaccination and prioritising people at highest risk, which were also provided in plain English to meet the needs of the HIV community.
- Clinical guidance on prescribing and care during restricted access to clinics and usual monitoring.
- Critical care guidelines co-badged with the Intensive Care Society.
- Regularly updated evidence summaries and recommendations co-badged with the European AIDS Clinical Society (EACS) and other European national HIV societies.
- Successful lobbying of DHSC with other national bodies and community groups to remove online COVID-19 testing restrictions for people with HIV (indeed, for all people with immunosuppressive conditions).
- In addition to plain English guidance, producing webcasts and video community Q&A pieces.
- A simple vaccine safety video tailored for clinic use, developed by BHIVA members at the Homerton sexual health service.
- Development of a specific COVID-19 chapter to BHIVA’s comprehensive vaccine guidelines.
- An international HIV conference symposium covering community experiences, HIV/COVID-19 interplay and myth-busting on potential COVID treatments.
- Contributions to analyses of national databases which demonstrated a higher risk of mortality for people with HIV.
- A national HIV clinic survey of COVID-19 cases.
- Input to a national survey of community COVID-19 experiences.
Persevering through uncertainty
Unknowns remain, not least how much the mortality signal is driven by HIV per se, versus other risk factors that impact people with HIV disproportionately. Regardless, we will continue to lobby, inform and to contribute to research to best manage this pandemic in any we may face in the future.
Updates to COVID-19 information are featured on the home page of BHIVA’s website, with a link to a COVID-19 specific section in the News section.
Read more at: www.bhiva.org/Coronavirus-COVID-19