COVID-19 and People with HIV

Content From: HIV.gov•Updated: October 25, 2024•8 min read

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How Does COVID-19 Affect People with HIV?

We are still learning about COVID-19 and how it affects people with HIV. Older age and having a weakened immune system can increase a person’s chances of getting very sick with COVID-19. Nearly half of people in the United States with diagnosed HIV are ages 50 and older. Also, people with weakened immune systems, such as people with advanced HIV (including an AIDS diagnosis) or people with HIV who are not on HIV treatment, have lower defenses against infections, and their bodies may have a harder time building lasting protection from past immunization or infection.

The good news is that there are actions you can take to protect yourself and others from health risks caused by COVID-19 and other types of respiratory viruses. These actions can help you lower the risk of COVID-19 transmission (spreading or catching COVID-19) and lower the risk of severe illness if you get sick.

Feeling sick? COVID-19 testing can help you know if you have COVID-19 so you can decide what to do next, like getting treatment to reduce your risk of severe illness and taking steps to lower your chances of spreading a virus to others. Follow CDC’s guidance on testing for COVID-19. If you test positive or if you have symptoms that aren’t better explained by a different cause, follow CDC’s steps to prevent the spread of respiratory viruses when you are sick. Keep taking your HIV medicine as prescribed. This will help keep your immune system healthy. If you are not taking HIV medicine, talk to your healthcare provider about the benefits of getting on HIV treatment. Not sick? Learn about other key times to get tested.

Need a test? Every U.S. household is eligible to order 4 free at-home COVID-19 tests at COVIDTests.gov. The tests are completely free – you won’t even pay for shipping. You can also buy self-tests (at-home tests) online or in pharmacies and retail stores. If you have health insurance, it may reimburse the cost of purchasing self-tests. Contact a community-based health center near you to find out about the availability of free or low-cost tests in your area.

COVID-19 treatment. If you test positive for COVID-19 and are more likely to get very sick, medications are available that can reduce your chances of hospitalization and death. Contact a healthcare provider right away to see if you’re eligible for treatment, even if your symptoms are mild right now. Don’t delay: COVID-19 treatment must be started within 5-7 days of when your symptoms first start to be effective. But be aware: some COVID-19 treatments can interact with antiretroviral therapy (ART) used to treat HIV. If you have HIV, let your healthcare provider know before starting COVID-19 treatment. For people without HIV who are taking PrEP to prevent HIV, there is no evidence that currently available medicine used to treat COVID-19 will interact with HIV PrEP.

COVID-19 Vaccines and People with HIV

Get vaccinated. CDC recommends everyone—including people with HIV—stay up to date on their COVID-19 vaccines.

Here’s what to know:

Everyone ages 6 months and older should get a 2024-2025 COVID-19 vaccine. This includes people who have received a COVID-19 vaccine before and people who have had COVID-19.
All people who are 65 years and older and those who have moderately or severely weakened immune systems should receive a second dose of 2024-2025 COVID-19 vaccine 6 months after their first dose and those with moderately or severely weakened immune systems may receive additional (i.e., 3 or more) doses in consultation with their health care provider. This includes people with advanced or untreated HIV.
The COVID-19 vaccine helps protect you from severe disease, hospitalization, and death.
It’s especially important to get your 2024-2025 COVID-19 vaccine if you are ages 65 and older, are at high risk for severe COVID-19, or have never received a COVID-19 vaccine.
Vaccine protection decreases over time, so it is important to stay up to date with your COVID-19 vaccine. Find out if you are up to date.
CDC’s COVID-19 vaccine recommendations will be updated as needed.

Learn more about CDC's recommendations. There is specific information for people with certain medical conditions and COVID-19 risk factors.

Vaccine safety. COVID-19 vaccines are safe for people with HIV and people with HIV were included in vaccine clinical trials. Also, there is no evidence that COVID-19 vaccines interfere with ART to treat HIV or PrEP to prevent HIV. Learn how getting a COVID-19 vaccine is a safer and more dependable way to build immunity to COVID-19 than getting sick with COVID-19. If you have questions about getting COVID-19 vaccine and whether it is right for you, talk to your health care provider.

Visit vaccines.gov or call 1-800-232-0233 to find a COVID-19 vaccine near you.

Long COVID

Long COVID is broadly defined as a wide range of signs, symptoms, and conditions that continue or develop after acute COVID-19 infection or reinfection. It occurs more often in people who had severe COVID-19 illness, but anyone who gets COVID-19 can experience it, even children. Some groups of people are more likely to develop Long COVID than others, including people with underlying health conditions and adults who are 65 or older, as well as people who didn’t get a COVID-19 vaccine.

Health inequities from disability, economic, geographic, and other social factors disproportionately affect some groups of people. These inequities can increase the risk of negative health outcomes and impact from Long COVID. However, scientists are still working to understand which people or groups of people are more likely to have Long COVID, and why.

There is no laboratory test that determines if your symptoms or condition are due to COVID-19. Long COVID is not one illness. Your healthcare provider considers a diagnosis of Long COVID based on your health history, including if you had a diagnosis of COVID-19 either by a positive test or by symptoms or exposure, as well as doing a health exam. The best way to prevent Long COVID is to protect yourself and others from getting a severe case of COVID-19, including by staying up to date with COVID-19 vaccines.

Learn more about Long COVID and its symptoms.

COVID-19 and HIV: Federal Resources

Below are resources about COVID-19 from agencies across the federal government that may be helpful for people with HIV and the health care providers and organizations who work with them.

Centers for Disease Control and Prevention (CDC)

CDC Respiratory Virus Guidance—This guidance provides practical recommendations and information to help people lower their risk from a range of common respiratory viral illnesses, including COVID-19, flu, and RSV.
CDC Respiratory Viruses and People with Weakened Immune Systems—This section of the CDC Respiratory Virus Guidance provides specific considerations for people who are at higher risk for severe illness from COVID-19 and other respiratory viruses, including people with weakened immune systems.

Health Resources and Services Administration (HRSA)

COVID-19 Information for Health Centers and Partners—This HRSA Health Center Program page provides the latest information on COVID-19 for health centers and Health Center Program partners. HRSA-funded health centers are a vital part of the nation’s response to HIV.
HRSA HAB COVID-19 Information—This HRSA HIV/AIDS Bureau (HRSA HAB) page provides links to resources for Ryan White HIV/AIDS Program (RWHAP) recipients, subrecipients, and stakeholders on COVID-19.

National Institutes of Health (NIH)

NIH Mental Health Resources—NIH has compiled this library of mental health resources related to COVID-19 and mental illnesses and disorders. Good mental health is essential to successfully treating HIV.
NIDA: COVID-19 and Substance Use—This NIDA page of COVID-19 resources includes FAQs on COVID-19 and addiction/substance use disorder.

Substance Abuse and Mental Health Services Administration (SAMHSA)

Overview of the Impacts of Long COVID on Behavioral Health (Jan 2023)—This report discusses the cognitive and psychiatric impacts of Long COVID on behavioral health.
SAMHSA.gov/coronavirus—This site provides COVID-19 guidance and resources to assist individuals, providers, communities, and states.

U.S. Department of Health and Human Services (HHS)

The Office of Long COVID Research and Practice—This office works across the U.S. Government to coordinate the whole-of-government response to the longer-term impacts of COVID-19 including Long COVID and associated conditions.
The Implementation of the Government-Wide Response to Long COVID (Feb 2024)— This report details the activities the federal government is undertaking to meet its Long COVID goals and objectives.
National Research Action Plan on Long COVID (Aug 2022)—This report provides a unified overview of ongoing federal research on Long COVID, including over 75 research projects and hundreds of published articles. It also lays out a path for future inquiry.
Services and Supports for Longer-Term Impacts of COVID-19 (Aug 2022)—This report outlines over 200 federally funded programs, supports and services, from housing and financial assistance programs to child care support, that may be available to those impacted by Long COVID.

U.S. Department of Health and Human Services (HHS) Administration for Community Living

Strategies to Improve Equitable Vaccine Access for Older Adults and People With Disabilities (April 2021)—This is a compilation of strategies and best practices for helping older adults and people with disabilities access COVID-19 vaccines. More than half of people in the U.S. with diagnosed HIV are over age 50.

U.S. Department of Health and Human Services (HHS) Office for Civil Rights

HHS OCR Guidance on Federal Legal Standards Prohibiting Disability Discrimination in COVID-19 Vaccination Programs (April 2021)—People with or at risk for HIV who have disabilities and those who work with them may find this information useful. (Related fact sheet.)

U.S. Department of Housing and Urban Development (HUD)

HUD HOPWA COVID-19 Guidance and Resources Exit Disclaimer—This page offers COVID-19 guidance and resources for the grantees of HUD’s Housing Opportunities for People with AIDS (HOPWA) Program.