San Francisco Chronicle - (Sunday)
HIV and COVID19: A tale of two pandemics
The world now faces an unprecedented global emergency with the most lethal new pandemic since the emergence of AIDS nearly 40 years ago.
In a few short months, COVID19 has swept the globe, affecting more than 8 million people with deaths approaching half a million at the time of this writing.
For the tens of millions of people living with or affected by HIV — and the 8 million who do not know that they are HIV positive — the pandemic has brought immense challenges.
The shifts that countries have set in motion within their health systems and economies to adapt to the coronavirus pandemic threaten to deprioritize the urgent, ongoing needs of people living with HIV and derail decades of hardwon progress in the response to HIV.
The coronavirus pandemic has highlighted the shortcomings of health systems along with gaps in governments’ epidemic control policies.
Many of the negative impacts from COVID19 have come from countries pulling much needed attention and resources from the HIV response to manage the pandemic.
As a result, access to treatment, clinical services, and psychosocial support has suffered. People most vulnerable to HIV — men who have sex with men, people who inject drugs, sex workers and transgender people — have experienced renewed stigma and persecution.
At the same time, the resourcefulness and ingenuity of communities and health care workers across the world must be applauded. They have leveraged their HIV experience to drive the COVID19 response while ensuring access to HIVrelated services.
In South Africa, 38,000 of the 54,000 community health workers originally mobilized to scale up HIV and TB outreach now fuel the country’s COVID19 screening program. In Nepal, Indonesia, India and China, home delivery of HIV medication is a lifeline for those who cannot access clinics.
Closer to home in the Bay Area, social support programming for longterm HIV survivors and other community groups is occurring online. HIV organizations are delivering food and cleaning supplies to more than 100 households, and providing housing assistance to people living with HIV who are unable to shelterinplace.
HIV science has played its role in the COVID19 response too. The unprecedented speed in scientific innovation in the COVID19 response builds on 40 years of experience in responding to HIV — from advances in HIV testing using polymerase chain reaction and antibody tests to antivirals for disease treatment.
Yet like the HIV epidemic, COVID19 has quickly laid bare deep seeded stigma and inequalities in place long before the virus.
It has forced a global spotlight on issues all too familiar to the HIV community. Issues of healthcare and treatment access; financial and political commitment to finding a cure or vaccine; protecting our most vulnerable communities; and addressing the social and racial disparities that fuel its spread.
The global outcry against structural racism sparked by events in the U.S. has brought to the fore the sobering truth that racism is a public health crisis and that we will not advance without addressing racial injustice.
We must remain dedicated to eliminating stigma and disparities. Without addressing deepseated structural inequalities, HIV, COVID19 and other health crises like them, will continue to affect the most vulnerable people disproportionately wherever they may be.