In South Africa there are 7.5 million people living with HIV and of those, between 2 and 2.5 million are not currently on treatment.

High viral load among about 500 000 of these untreated HIV-positive people weakens their immune systems, which puts them at much greater risk of complications if they do contract COVID-19.

It was for this reason that the South African government took decisive action to contain the spread of the virus through a lengthy lockdown. This time has been spent preparing and strengthening the health system to deal with potentially high numbers of COVID-19 cases who require medical attention.

Is COVID-19 worse in people living with HIV? 

Currently there is no evidence of HIV-positive people who are on effective treatment being at higher risk of Coronavirus infection.

“As long as you are managing your HIV well by taking antiretroviral drugs – or ARVs –  properly every day, you are no more likely to develop severe COVID-19 symptoms than anyone else,” says Antoinette Stafford-Cloete, Health Systems Trust Communications Manager.

But if you are not on ARVs, or if you are not adhering to your treatment, your immune system may not be strong enough to fight off infections effectively. This is because your HIV viral load is likely to be much higher, which is damaging your CD-4 ‘fighter’ cells.

Are some HIV-positive people at higher risk of getting seriously ill from COVID-19 than others?

Yes. If you are HIV-positive and have a weakened immune system, you are more likely to become very ill if you get COVID-19. This applies to HIV-positive people who:

  • have a low CD-4 cell count;
  • have a high HIV viral load;
  • have recently had an opportunistic infection like TB, and/or
  • are older than 60.

We also know that HIV-positive people who are not on treatment or are not taking their ARVs properly can develop respiratory infections more easily. An added respiratory infection in a COVID-19 patient will lead to more severe illness.

So what can you do to protect yourself from COVID-19 infection?  

The most important thing that you can do is to continue to take your medication. If you aren’t on ARVs, start immediately!

Visit your local clinic and ask about starting (or switching to) the new HIV treatment called TLD, which helps to suppress your viral load more quickly.

Are you worried about collecting your medication from a crowded clinic? Ask your nurse about the CCMDD programme. CCMDD is convenient new service that allows you to collect a two-month prescription of your medication from over 200 pick-up points rather than from the clinic. As long as your viral load is suppressed and any other chronic diseases that you may have are well managed, you will qualify to register on CCMDD.  Read more here.

What else can you do? 

  • Stock-up on your ARV treatment (and medication for any other chronic diseases that you may have), so that you have enough for at least 30 days, ideally for three months.
  • Follow the COVID-19 prevention steps like wearing a cloth mask whenever you are out of home (and washing it after every use), washing your hands regularly, and keeping social (physical) distance from others.
  • Make sure that you know how to get in touch with your healthcare facility, and that you have a support plan in place if you feel unwell and need to stay at home.
  • Try to eat well by avoiding foods high in fat and sugar, and keep exercising as best you can at home.
  • Your mental and emotional health is also important, because stress and depression can also weaken your immune system. Reach out to family and friends if you’re feeling low, and contact a counsellor at SADAG or LifeLine SA for expert help over the phone or online.

For support contact:

South African Depression and Anxiety Group

LifeLine SA