Managing Your Health During the COVID-19 Pandemic: Information for people living with HIV

What is COVID-19?

COVID-19 is a disease caused by the virus SARS-CoV-2. The virus can affect people differently.

Common symptoms of COVID-19 are:

  • fever
  • dry cough
  • tiredness

Less common symptoms include:

  • aches and pains
  • sore throat
  • diarrhea
  • headache
  • loss of taste or smell

Most individuals are infectious for several days before they develop symptoms. Some people who get COVID-19 never develop symptoms, but they can still transmit the virus to others.

Most people will experience mild to moderate illness and will recover on their own. However, about 20% of people diagnosed with COVID-19 will go on to develop severe illness. Some of these people may require hospitalization, and a few may require intensive care. A small number may die from COVID-19 infection.  

While anyone can experience severe illness from COVID-19, certain risk factors significantly increase the chance that a person will have severe illness.

What are the risk factors for serious illness for people living with HIV?

For people living with HIV, there are three main risk factors that can increase the risk of serious illness from COVID-19: a weakened immune system, underlying health conditions and older age.

Weakened immune system

A person with HIV who is on HIV treatment with an undetectable viral load and a strong immune system (CD4 count above 200) is not expected to be at higher risk of severe illness from COVID-19. However, a person who is not on HIV treatment and/or has a low CD4 count may be at increased risk of severe illness from COVID-19.

Underlying health conditions

Some people living with HIV may have other underlying health conditions that are known to increase the risk of serious illness from COVID-19. These health conditions include:

  • cancer
  • dementia
  • diabetes
  • heart disease
  • high blood pressure
  • kidney disease
  • liver disease
  • lung disease
  • obesity

Older age

The risk of serious illness from COVID-19 increases for everyone with age (regardless of HIV status). 

How is COVID-19 transmitted?

SARS-CoV-2 is the virus that causes COVID-19. It is transmitted through small droplets from the mouth, throat and nose of a person who is infected with the virus. Transmission occurs through close contact with a person who has the virus, contact with aerosols in enclosed spaces or through contact with contaminated objects or surfaces. 

Contact with people

The virus is transmitted through small droplets from the mouth, throat and nose of people when they breathe, talk, sing, laugh, cough or sneeze. When an individual is in close contact with someone who has the virus, these droplets containing the virus can enter their body through viral receptors in their eyes, nose or mouth. The virus cannot enter the body through skin. The closer and more prolonged the contact, the greater the chance of transmission. 

Contact with aerosols in enclosed spaces 

In enclosed spaces, very small droplets of the virus (called aerosols) may remain suspended in the air for longer periods of time. This means there is an increased risk of transmission in enclosed spaces, especially settings with poor ventilation. 

Contact with surfaces

Objects and surfaces can become contaminated when someone with the virus has been near them. Transmission can happen if someone touches a contaminated surface or object and then touches their eyes, nose or mouth without washing their hands first.

How can transmission of the virus be prevented?

The best way to prevent getting sick from COVID-19 is to avoid exposure to the virus.

Maintaining a distance of two metres from people outside your household or small social circle can help prevent transmission of the virus. Social circles are the limited number of people outside of your household with whom you have close physical contact. If you have a sex partner or partners outside your home, you may want to discuss arrangements to reduce your risk. For more on sex and COVID, see Sex and COVID-19.

When physical distancing is difficult, you should wear a new or clean non-medical face mask or face covering. You should also wear a new or clean face mask or face covering when you are in an indoor space with people not in your household or social circle. It is a good idea to reduce your time in indoor spaces with people outside of your household or social circle, particularly if there is singing, shouting or heavy breathing (e.g. exercising). 

You may notice healthcare workers wearing glasses or face shields — they do this to reduce the risk of droplets entering their eyes. Some jurisdictions have made it mandatory to wear non-medical face masks or coverings in public areas, such as on public transit and in shops. You should also try to avoid close contact with anyone who has been exposed to the virus or has symptoms of COVID-19, such as a fever or cough.

To prevent transmission from contact with contaminated surfaces, wash your hands frequently with soap and water or use hand sanitizer. Avoid touching your face with unwashed hands and regularly clean frequently touched surfaces with disinfectant.

The amount of virus in your community may change over time and therefore recommendations about entering public spaces and the maximum size of social groups may change. Consult your local public health authority for the latest guidance on how to prevent transmission of the virus.

What else can I do to protect my health during the COVID-19 pandemic?

It is important for people living with HIV to stay engaged in healthcare to remain healthy and minimize their risk of serious illness from COVID-19.

Early HIV diagnosis and ongoing treatment are important for everyone living with HIV to improve and maintain their health. People with untreated HIV may experience additional complications with COVID-19. If you are not already on HIV treatment, consider starting treatment as soon as possible. If you are on treatment, ongoing adherence is also important. This means taking your medications regularly as prescribed without missing doses. If you are having trouble sticking to your treatment schedule, be sure to discuss this with your healthcare provider so that together you can find solutions.

It’s important to stay engaged with your HIV care team and manage any related health conditions, as these may increase the risk for serious illness from COVID-19. The list of what health conditions increase the risk of more severe illness with COVID-19 may change as we learn more about the disease.

It’s also important to stay up to date on vaccinations, including the annual influenza vaccine, as these can help to prevent complications if you become ill with COVID-19.

There are many other ways to look after your physical and mental health during the pandemic. Make sure to try to get fresh air and regular exercise outside your home if you are permitted to. It can also be helpful to establish a routine, whether you are working or not. It’s important to regularly connect with others, especially if you live alone; try using video or phone calls to stay in touch with friends or family. If you find yourself feeling depressed or anxious, talk to your healthcare provider.

Consider preparing for the possibility that you may be asked to self-isolate because you have been in contact with someone with COVID-19 or because you yourself have become infected with COVID-19. Discuss with your network of family, friends and support workers how you can get food, medications or other support during self-isolation.

Will COVID-19 affect my HIV care?

Because of physical distancing measures during the COVID-19 pandemic, there may be some changes to your HIV care. Your regular monitoring appointments with your healthcare provider or lab tests may be less frequent. Video and phone calls may replace face-to-face appointments with your healthcare team. Despite these changes, it is very important to stay engaged in HIV care.

There may be some changes to the way your medications are dispensed. It is recommended that people with HIV be given enough medication to last three months or more to avoid unnecessary trips to the pharmacy. Discuss your options with your healthcare provider and your pharmacist to make sure you always have enough medication on hand.

What should I do if I think I have COVID-19?

Each province and territory has COVID-19 helplines or websites that provide information on what to do if you think you have COVID-19.

If you suspect you have been exposed to COVID-19, you should isolate yourself and follow recommendations from your province or territory. If you are diagnosed with COVID-19, you may be contacted by a public health worker who will ask for details about anyone you may have come into contact with. These people should also be tested for COVID-19 and self-isolate until they receive the results.

If you have COVID-19, follow the advice of your local public health authorities regarding how long you should self-isolate. Usually it is recommended that you stay isolated for at least 14 days, or until 7 days after the last day of symptoms. Remember to drink plenty of fluids and rest well. If you have a fever, take painkillers to help bring it down.

Seek immediate medical attention if your symptoms become severe, such as if you have shortness of breath, chest pain or a persistent high fever.

Research has found that during the COVID-19 pandemic, some people are not seeking medical care to address health problems other than COVID-19. To stay on top of these issues during the pandemic, it is important to remain engaged in your healthcare and to discuss all of your symptoms with your healthcare provider.

The information on this page is based on available research related to the transmission and prevention of COVID-19. This resource will be updated as new evidence emerges. Last updated November 25, 2020.