Pandemic Reawakens Trauma for Those Living with HIV

The impact of COVID-19 has been traumatic for many, but for those living with HIV the pandemic may have reawakened feelings of social exclusion and fear with receiving a positive status. 

“I’m an HIV positive person and I just survived COVID-19 infection. We positive folks can be healthy, too,” said Amahl Azwar, 33-year-old freelance writer for VICE.

Azwar said that prior to the pandemic, he noticed when individuals were aware of a person’s HIV status, they would often take extra cleanliness precautions such as wiping down surfaces multiple times.

“If I just tell them this person has HIV, they won’t even sit with them, and it’s really not that easy to contract. I still get questions like, ‘Can you get HIV from sweat?’ It’s a never-ending process to educate people,” said Azwar. 

However, he noticed those precautions were not similarly taken to prevent the transmission of COVID-19. 

“I found it baffling because COVID is easier to get than HIV, and I saw that people just didn’t care about that,” said Azwar.

Azwar was diagnosed with HIV back in 2013 when he was getting tested for another sexually transmitted disease. A year later, after a downward depression which led to his firing, Azwar finally sought treatment in the form of taking antiviral medications, and healing through the process of writing about his experience with coming out and having HIV. 

“I didn’t really feel like many guys like me were open about their sexuality, and open about their situation with their HIV, but little by little I started to open up and I felt more empowered,” said Azwar.

Since that time, he has continued to take antiretroviral therapy medications, like Dolutegravir, which help to control viral loads and prevent other illnesses. 

“We have a method to prevent COVID infection and HIV progression, but some people do not want to take it. Every HIV patient I have, it’s safer for them to take medications, and it does more harm than good to not take it,” said Theresa Mack, medical director at Mount Sinai Doctors Faculty Practice.

Despite the fact that there is no 100% cure for HIV, Azwar continues to encourage those living with HIV, who don’t believe it can be managed, to take antiretroviral therapy medications.

“As long as we take our antiretroviral therapy medications, we can handle other diseases including COVID,” said Azwar. 

That’s why when Azwar tested positive for COVID-19 on June 22, he felt that having HIV would not impact his chances of recovery, although there were many friends and family who worried because of the dual positive status. 

“Even people without HIV die and give up because of COVID, so they know when someone like me has HIV and COVID they are worried,” said Azwar.

“If you have HIV and are not protected by the vaccine then your chances of getting a severe COVID infection and consequences is high,” said Mack. 

During his quarantine, Azwar experienced symptoms like fatigue, headaches, and breathing difficulty, but he handled it through online therapy and calls to help lines. 

Studies show that chronic depression, stressful events, and trauma may negatively affect HIV disease progression in terms of decreases, and Azwar, who was aware of these findings, was careful to avoid stress during the period he was sick with COVID-19.

 “If I’m not taking care of myself or stress-level, it’s easy to feel unwell,” said Azwar. 

“Stress factors can progress it, if we don’t treat your depression, how you are going to take your medicine, or if you don’t have a place to live where you will keep your medicine,” said Mack. 

Azwar tested positive despite having received his first vaccine shot in May and was informed to continue his medication as usual and felt it was a positive experience, but he said this wasn’t the case for many of his friends who experienced stigma from providers regarding their HIV status when going to receive the vaccine shot because of fears of exposure. 

According to Mack, another issue for those living with HIV who are receiving the vaccine has been a decrease in viral load after long periods of no detection. 

“The vaccine may increase viral loads, and it’s not just the COVID vaccine, it’s any vaccine, and we see this in patients who even get flu vaccines. They get fearful of an increase in viral load, especially if they have been undetectable for so long, and they start to see the elevated viral load and think their HIV medicines aren’t working,” said Mack. 

On July 5, Azwar tested negative for COVID and has resumed a normal course of habits like working out at home or eating healthy foods to keep himself physically healthy and mentally happy. 

Although the pandemic has stirred up new feelings of social exclusion regarding a positive status, he finds it may have shifted perceptions of health to be more inclusive to those living with HIV. 

“I do see that people are becoming more and more aware about health, and really aware about washing hands, or taking vitamins, or managing stress level, or getting one hour of sun, and it’s not new, but the awareness of it is becoming even more visible during the pandemic. This attitude could be applied to other types of stigma that we need to face, like HIV,” said Azwar. 

“I don’t think COVID has played any part in decreasing the stigma of HIV, but it may make the public more aware of other viruses,” said Mack.