As COVID-19 numbers rose, so did HIV. Some organizations have partnered with COVID testing teams to also provide HIV testing. (Photo Credit: The Gender Spectrum Collection via VICE.com)

Those of us who were of age in the 1980s remember all too well how a devastating virus ravaged the gay community. On June 5, 1981, the U.S. Center for Disease Control (CDC) published an article describing cases of Pneumocystis Carinii Pneumonia (PCP), a rare lung infection found in five unacquainted young white gay men in Los Angeles, all of them previously healthy.

The CDC’s Dr. Wayne Shandera, immunologist Dr. Michael Gottlieb and their colleagues reported that the five young men had other unusual infections as well. The infections, they explained, were indicators of weakened immune systems.

By the time the article was published in the CDC’s Morbidity and Mortality Weekly Report (MMWR), two of the young men (believed to be symptomatic between October 1980 – May 1981) had already died. The infection they died from shortly became known as Acquired Immune Deficiency Syndrome (AIDS).

After nearly two decades of initial research and development (which continues today), intervention and prevention methods and medication that has evolved from those combined efforts, AIDS is now an acronym rarely heard or utilized.

In 2021, after millions of AIDS-related deaths in the past and vast medical advances, HIV (Human Immunodeficiency Virus) continues to infect people, but far fewer cases grow to full-blown AIDS. 

AIDS occurs when an HIV positive individual has gone without proper treatment and care. Both HIV and AIDS damage an individual’s immune system, interfering with the body’s ability to fight off infection and disease.

According to the Mayo Clinic, the progression from untreated HIV to AIDS can take eight to 10 years. Along the way, however, the body’s ability to fight off infection and disease can be compromised as HIV destroys CD4 cells (also known as T cells and white blood cells) that greatly assist in fighting disease. It becomes more likely that an infected person would develop opportunistic infections and cancers, along with other diseases that would generally not appear in a person with a healthy immune system. The fewer CD4 cells you have, the weaker your immune system becomes.

It is a sexually transmitted infection (STI) and can also be spread by contact with infected blood or from mother to child during pregnancy, childbirth or breast-feeding.

These days, the newest and most recent viral culprit we hear so much about isn’t HIV, it’s COVID-19.

Unlike HIV, COVID-19 isn’t defined as a sexually transmitted infection, although it can be passed from one person to another through saliva during a kiss ,and it has been found in semen of men who have tested positive for COVID-19.

Predominantly, it is believed to be transmitted through respiratory droplets produced when an infected person coughs or sneezes, creating a scenario that makes the possibility of infection even more frightening. 

Although most people who have COVID-19 have mild symptoms, it can also cause severe illness and even death. Despite the massive rollout of multiple vaccines and the decline of deaths in recent months, it’s important to note 2.76 million people have died globally and nearly 550,000 of those individuals perished here in the United States.

In the wake of all this, many people have wondered how one virus impacts the other when it comes to transmission, infection rates and care.

With so much focus on COVID-19, health care professionals and at-risk community members are wondering if campaigns like “Getting to Zero” and “Ending the Epidemic of HIV” will lose traction in the wake of the COVID-19 pandemic.

Like most things, there’s more than one side to this nuanced issue; particularly since those with weakened immune systems are at greater risk for contracting COVID-19. That being said, healthcare organizations have had to prioritize staffing and funding to keep up with rising numbers in HIV and COVID-19 while looking at and utilizing innovative methods in meeting the needs and demands HIV prevention calls for.

Some organizations, like The PowerHouse Project (the intervention and prevention division of Quality Comprehensive Health Services), have partnered with COVID-19 testing teams (who made themselves available to disadvantaged at risk communities) to continue to provide free HIV testing and referral resources.

This was especially necessary during a time of business shutdowns and state lockdowns, which often prevented people from leaving their homes to access services that may not have been considered essential.

Larger organizations like the Mecklenburg County Health Department rolled out programs that allowed residents to receive free HIV home testing kits.

Others took to social media platforms to bolster messages of safe-sex practices, HIV testing and ways of accessing Pre-exposure Prophylaxis (PrEP), a course of HIV drugs (generally one daily pill) taken by HIV-negative people to prevent HIV infection.

On March 25, the NC AIDS Action Network (NCAAN) hosted a webinar: HIV and the COVID Vaccine. NCAAN’s Health Access Coordinator, J. Donte Prayer, discussed the connection of the two viruses and COVID-19’s impact on HIV. 

“Even [with] COVID-19, we still need to ensure there is adequate and continuous awareness around HIV and HIV-impacted communities. Health care agencies have been so tapped into COVID testing and vaccine administering that HIV prevention has somehow been lost in the fervor, which is odd because HIV is often brought up in conversation by people comparing COVID-19 with HIV.” 

The comparisons Prayer spoke of are often discussions on disparities. To date, HIV impacts the Black gay and/or Black men who have sex with men communities more than any other. Like so many other health conditions, the Black community is often hit hardest, with HIV carrying a stigma deeply rooted within families and faith-based communities.

Adding insight to the issue of the relationship between COVID-19 and HIV is Patrice Marsh, a prevention case manager for RAIN (Regional AIDS Inter-faith Network). RAIN is an intervention and prevention organization that aims to empower persons living with HIV and those at risk to be healthy and stigma-free.

Marsh confirms COVID-19’s impact on HIV has directly resonated with communities and health organizations. As a result of COVID-19, her clients now have access to software like Docusign, enabling them to sign forms and other documents from their homes. Marsh continues to take all necessary precautions in accompanying clients to initial clinic visits, but subsequent visits, including mental health appointments are held virtually.

The same is true for many organizations in the wake of COVID-19. Marsh believes this has “helped a lot of people with the uncertainty, stress and anxiety” the pandemic has produced.

While noting an uptick in PrEP enrollments (from about May to November 2020), of particular concern was how popular sex parties have become.

“[With] people being confined to their homes, and limited social interaction, a lot of single people who would normally be dating [in person] and going out, COVID sex parties have become popular,” Marsh explains.

“Sex parties aren’t new, but what is new is the desire to get out of the house and have some social contact. As a result we’ve seen an uptick in [HIV] positives. So we started doing live streams, talking about a little bit of everything — but primarily to address this.”

While it is regrettable, COVID-19 precautions are all too often being dismissed and safer sex practices sometimes go ignored by those using PrEP; there’s no question that health workers and members of the community are working diligently to quell the spread of COVID-19 and HIV alike.

Clearly, it’s important to remain vigilant. By closing the gaps in health care disparities through empathy, access and education, we can hope for a future where both viruses will remain controlled and eventually eradicated.

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