Coping with HIV in a pandemic

People living with HIV are hit with a double whammy: not only do they have to maintain their treatment but they are also a vulnerable group that must be extra vigilant against Covid-19.

SALMAH (not her real name), 38, earns a living as a nanny, looking after children whose parents work as teachers. But since schools closed due to the Covid-19 pandemic, her services have not been needed. So she has no income now.

On top of that, Salmah has been living with HIV for the past 15 years.

“My husband is also unwell and unemployed. I’m afraid because I have to take medication every day to cope with HIV. I am worried that my supply will be affected,” says Salmah, who has been geting her medicine through Pos Laju services during the conditional movement control order (MCO).

Such is the predicament of some people living with HIV (PLHIV) in these trying times.

Another person living with HIV who wishes to be known only as Hani, 54, also struggles to make ends meet as a stall operator and as a single mother of three children.

“I hope I will be able to carry on with life. I have to be brave as I am alone,” she says.

There are about 75,040 people living with HIV in Malaysia now. The Covid-19 outbreak has added another layer of anxiety in a community already living on the edge and deeply vulnerable to stigma and discrimination.

Even for younger PLHIV like Maza (not his real name), 30, who doesn’t have dependants, such uncertain times have filled him with worry. He is afraid of the pandemic that has claimed over 300,000 lives worldwide.

“I was very worried that this new virus would knock us out. We know that the virus can be unforgiving for people with underlying health complications like diabetes, hypertension and cancer,” says Maza, a social worker.

Every day, he looks into his medicine cabinet just to feel safe that he has enough HIV medication to get by.

During such unprecedented times, people living with HIV are hit with a double whammy. On the one hand, they must keep up with their medication to cope with HIV. And on the other, they must be extra cautious about Covid-19.

According to the World

Health Organisation (WHO), people living with HIV in whom the disease has advanced, who have a low CD4 (immunological cell) count and those who are not on treatment have an increased risk of infections in general.

“It is unknown if the immunosuppression of HIV will put a person at greater risk for Covid-19. Thus, until more is known, additional precautions for all people with advanced HIV or poorly controlled HIV should be employed,” WHO advises at its website.

It was reported that there were 3,293 new HIV infections in 2018, based on the country progress report on HIV/AIDS 2019 for Malaysia.

On a positive note, the number of new HIV cases has been steadily declining over the years.

But the Malaysian AIDS Foundation (MAF) points out that in Malaysia, four out of 10 HIV positive diagnoses remain untreated. This roughly translates to about 30,000 individuals who are oblivious about their HIV status.

“We can only guess how many among them are immunocompromised and are at bigger risks of contracting the coronavirus,” says MAF chairman Prof Datuk Dr Adeeba Kamarulzaman.

Although Malaysia appears to be on the right track to control Covid-19, transmission of the virus is expected to continue post-MCO.

“HIV treatment is therefore the best way to shield this community from the worst of the Covid-19 pandemic,” she says.

In the meantime, Dr Adeeba is thankful that our healthcare system is still capable of providing care and support for people living with HIV.

“Some adjustments were made to accommodate the MCO and avoid PLHIV being infected with the coronavirus in hospitals.

“For example, patients will receive an ARV (antiretroviral) supply for up to one year,” she says.

The MAF has also set up the AIDS Solidarity Fund to collect donations from the public to prevent a potential outbreak of the coronavirus within the HIV community who haven’t started their ARV treatment.

“We also wish to continue our community resilience programmes that will help PLHIV to rise above these challenges,” says Dr Adeeba in appealing to the public and corporations to contribute to the fund.

MAF is targeting to collect RM500,000 by the end of this year.

All proceeds to the AIDS Solidarity Fund will support the continuity of programmes such as the Paediatric AIDS Fund, which is a monthly subsistence programme for children living with HIV or raised in households impacted by HIV.

Other programmes include the PAL Scheme, a special ARV subsidy programme rolled out at seven major HIV referral hospitals and clinics across Malaysia. Those earning less than RM2,000 per month are entitled to receive a monthly supply of the life-saving

medication from

MAF under the scheme.

“The PAL Scheme has been around for over a decade. We were able to sustain this programme through public donations and also support from major donors,” Dr Adeeba says.

Some people living with HIV who are able to pay for treatment previously are now in a precarious situation due to the current economic fallout from the pandemic.

“Some have lost their jobs while others suffered massive loss of income in the past months. They are also reaching out to MAF for help during this difficult time,” she says.

MAF also continues to support female entrepreneurs living with HIV with microcredit and business continuity plans through its MyLady Assistance Scheme.

“We are hopeful that the money raised will serve as an enduring symbol of solidarity with Malaysians living with HIV who are also deeply affected by the

pandemic,” says Dr Adeeba.

For more information about the AIDS Solidarity Fund, visit solidarity.yam.org.my or contact Razif Zainuddin at 011-3976 8083 / maf@mac.org.my. Donations to the Malaysian AIDS Foundation are tax exempt.