Resources
COVID-19

Resources Supporting the Intersection of COVID‑19 and the HIV Pandemics

HANC formed the COVID-19 CAB Coalition in September 2020 to share information, facilitate resource sharing and advocate on the behalf of the overall COVID-19 research efforts. ​

HANC, together with the COVID-19 CAB Coalition, maintains and updates this page focused on information about the COVID-19 pandemic and its intersection with the HIV pandemic.

COVID-19 Terminology, Guidelines and Resources

Coronavirus disease 2019 (COVID-19) is the infectious disease caused by the most recently discovered coronavirus. This new virus and disease were unknown before the outbreak began in Wuhan, China, in December 2019. The new virus that causes COVID-19 illness has been named severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2).

According to the World Health Organization

The most common symptoms of COVID-19 are fever, tiredness, and dry cough. Some patients may have aches and pains, nasal congestion, runny nose, sore throat or diarrhea. These symptoms are usually mild and begin gradually. Some people become infected but don’t develop any symptoms and don't feel unwell. Most people (about 80%) recover from the disease without needing special treatment. Around 1 out of every 6 people who gets COVID-19 becomes seriously ill and develops difficulty breathing. Older people, and those with underlying medical problems like high blood pressure, heart problems or diabetes, are more likely to develop serious illness. People with fever, cough and difficulty breathing should seek medical attention.

Background on Coronaviruses from the NIH

Coronaviruses are a large family of viruses that usually cause mild to moderate upper-respiratory tract illnesses, like the common cold, in people. However, three times in the 21st century coronavirus outbreaks have emerged from animal reservoirs to cause severe disease and global transmission concerns.

There are hundreds of coronaviruses, most of which circulate among animals including pigs, camels, bats and cats. Sometimes those viruses jump to humans—called a spillover event—and can cause disease. Seven coronaviruses are known to cause human disease, four of which are mild: viruses 229E, OC43, NL63 and HKU1. Three of the coronaviruses can have more serious outcomes in people, and those diseases are SARS (severe acute respiratory syndrome) which emerged in late 2002 and disappeared by 2004; MERS (Middle East respiratory syndrome), which emerged in 2012 and remains in circulation in camels; and COVID-19, which emerged in December 2019 from China and a global effort is under way to contain its spread. COVID-19 is caused by the coronavirus known as SARS-CoV-2.

Thanks to research investments into the SARS and MERS outbreaks, NIAID scientists and grantees are better prepared to develop diagnostics, therapeutics and vaccines against COVID-19. Included in those projects are basic research to understand how the virus infects cells and causes disease; adapting platforms used to develop diagnostic tests and vaccines; and evaluating treatments such as broad-spectrum antivirals and potentially monoclonal antibodies.

Note: COVID-19 is an emerging, rapidly evolving situation.

Resources

Center for Disease Control and Prevention

Access the latest public health information from the CDC and explore frequently asked questions, including COVID-19: What people with HIV should know.

National Institutes of Health

As the pandemic has evolved, so have NIH’s response and strategies. Learn more about the latest research, testing, treatments & vaccines and how to participate in clinical trials.

World Health Organization

View the latest in public advice and technical guidance from the World Health Organization. The public site also features a global research database with literature dedicated to the coronavirus disease.

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AIDSinfo

Interim Guidance for COVID-19 and Persons with HIV 
This interim guidance reviews special considerations for persons with HIV and their health care providers in the United States regarding COVID-19. Information and data on COVID-19 are rapidly evolving. This guidance includes general information to consider. People with HIV who have COVID-19 have an excellent prognosis, and they should be clinically managed the same as persons in the general population with COVID-19, including when making medical care triage determinations.

This interim guidance was prepared by the following working groups of the Office of AIDS Research Advisory Council:

  • HHS Panel on Antiretroviral Guidelines for Adults and Adolescents
  • HHS Panel on Antiretroviral Therapy and Medical Management of Children Living with HIV
  • HHS Panel on Treatment of Pregnant Women with HIV Infection and Prevention of Perinatal Transmission
  • HHS Panel on Guidelines for the Prevention and Treatment of Opportunistic Infections in Adults and Adolescents with HIV
  • HHS Panel on Opportunistic Infections in HIV-Exposed and HIV-Infected Children

Clinicians should refer to updated sources for more specific recommendations regarding COVID-19.

(Last Updated: February 26, 2021)

NIH HIV/AIDS Clinical Trials Networks

The NIH HIV/AIDS Clinical Trials Networks (ACTG, HPTN, HVTN, IMPAACT and MTN) have all issued guidance on the status of new and ongoing studies, viewable in the HIV/AIDS Clinical Trials Network Response to COVID-19 section on this page. Contact your site or network if you have questions about specific ongoing studies. Find additional guidance specific to laboratories in the Laboratory Resources section on this page.

European Medicines Agency (EMA)

Guidance on the Management of Clinical Trials during the COVID 19 (Coronavirus) Pandemic
The European Medicines Agency (EMA) and collaborators have prepared a document that sets out to include most of the current guidance across Member States with the aim of serving as a harmonised EU-level set of recommendations to mitigate and slow down the disruption of clinical research in Europe during the public health crisis.

FDA

Conduct of Clinical Trials of Medical Products during the COVID-19 Pandemic
The FDA has issued this guidance to provide general considerations to assist sponsors in assuring the safety of trial participants, maintaining compliance with good clinical practice (GCP), and minimizing risks to trial integrity for the duration of the COVID-19 public health emergency.
(Last updated: January 27, 2021)

NIH

Guidance for NIH-funded Clinical Trials and Human Subjects Studies Affected by COVID-19 (Notice Number: NOT-OD-20-87)
This notice provide guidance outlining the flexibilities available to recipients conducting NIH-funded clinical trials and human subject studies that are impacted by the declared public health emergency for COVID-19. 

Flexibilities Available to Applicants and Recipients of Federal Financial Assistance Affected by COVID-19 (Notice Number: NOT-OD-20-86)
The purpose of this notice is to alert the community of administrative flexibilities that will apply to NIH applicants and recipients. These flexibilities are applicable to NIH applicants and recipients where the entity is conducting research activities related to or affected by COVID-19. 

NCI

NCI Interim Guidance for Patients on Clinical Trials 
Due to concerns regarding the spread of the novel coronavirus and the impact it is having on hospitals, clinics, physician offices, and patients’ ability to travel, the NCI Cancer Therapy Evaluation Program (CTEP) and the NCI Community Oncology Research Program (NCORP) have provided clarification on measures to address some of the current challenges in providing care to patients enrolled on clinical trials in order to mitigate any immediate hazards.
(Issued March 13, 2020)

SAHPRA

SAHPRA Policy on Conduct of Clinical Trials of Health Products During the Current Covid-19 Pandemic
The South African Health Products Regulatory Authority (SAHPRA) is committed to providing timely health products regulatory guidance in support of continuity for stakeholders and appropriate timely regulatory response during the current COVID-19 pandemic. Specifically, this communication provides assistance to sponsors and applicants including clinical research organizations (CROs) in assuring the safety of trial participants, maintaining compliance with current good clinical practice (GCP), and minimizing risks to trial integrity during the COVID-19 pandemic. 
(Issued March 25, 2020)

American Academy of HIV Medicine

Considerations & Suggested Practices for Ambulatory HIV Specialty Care During COVID-19 Pandemic
As part of the American Academy of HIV Medicine’s commitment to provide relevant and useful information during the COVID-19 pandemic, please find attached a Spanish translation of the newly released guidance on COVID-19 and HIV care.

View the Spanish Translation

Infectious Disease Society of America (IDSA)/HIVMA

COVID-19: Special Considerations for People with HIV
Created by the Infectious Disease Society of America (IDSA) and the HIV Medical Association (HIVMA), this document on COVID-19 considerations for people living with HIV (PLWH) is intended as a resource for clinicians and public health officials.
(Version: April 17, 2020)

COVID-19 Real-Time Learning Network
The Infectious Disease Society of the USA (IDSA) has curated library of COVID-19 clinical guidance, institutional protocols, clinical trials data, practice tools and resources from a variety of medical subspecialties around the world. The site is regularly updated as resources and new information become available.

British HIV Association

British HIV Association Website
All BHIVA statements related to Coronavirus (COVID-19) and HIV are available on the BHIVA website. Statements include guidance on initiation of antiretroviral treatment (ART) during the coronavirus pandemic, HIV services, SARS-CoV-2 antibody testing for people living with HIV, vaccine advice for adults living with HIV, and additional FAQs and advice for people living with HIV.

Journal of the International AIDS Society (JIAS)

HIV and COVID-19 Virtual Issue
This collection of papers explores emerging insights about the epidemiology and biology of SARS-CoV-2, as well as the social and structural factors potentiating spread and responses to contain the pandemic. Unique clinical features of SARS-CoV-2/HIV-1 co-infection are also discussed.

The Virtual Issue is continuously updated to include new articles as they are being published.

(Last updated: November 27, 2021)

HIV Treatment Bulletin (HTB)

HIV Treatment Bulletin - COVID-19 Special Issue
The March 27, 2020 edition of the HIV Treatment Bulletin (HTB) is on the global health crisis related to the new coronavirus (SARS CoV-2) and COVID-2019 and the effect it will have for people living with HIV. 

HIV and COVID-19: i-Base articles and links
The i-Base COVID-19 page also includes new articles, Q&A posts, and non-technical links with information specific to people living with HIV.

NAM

No increased coronavirus risk for people with well-controlled HIV say WHO, but how will health systems cope?
Initial data from Wuhan, China, dating back to March 2020, suggested that people living with HIV suffered no worse a coronavirus epidemic than other people in the city, and confirmed the World Health Organization’s position that people with well-controlled HIV do not appear to be at elevated risk of coronavirus infection or severe disease. Nonetheless, the risk of disruption to HIV services is significant, especially as the new coronavirus spreads to countries with fragile health systems.

NAM has since released additional reporting on HIV programming during the COVID-19 pandemic and impacts on people with HIV.

POZ Magazine

POZ #Coronavirus
The POZ Coronavirus (COVID-19) page includes information about how the new coronavirus affects people living with HIV. Although older people, those with other health conditions and people with compromised immune systems remain most at risk of severe illness from the new coronavirus, everyone should be vigilant.

Clinical Care Options

COVID-19 Comprehensive Resource Center
The Clinical Care Options (CCO) COVID-19 Comprehensive Resource Center hosts a repository of MedicalMinute Updates, Q&A webinars, and slide sets to communicate the latest data on COVID-19 epidemiology and clinical management, best practices, and ongoing research.

HIV and COVID-19: What Do We Know Now?
The MedicalMinute Update from December 10, 2020 discusses HIV and COVID-19: What Do We Know Now and reviews the relationship between HIV infection and COVID-19 outcomes.

Clinical Care Options HIV
More information specific to the intersection between SARS-CoV-2 and HIV, particularly among special populations such as aging patients with HIV infection or pregnant women with HIV, is found under the CCO HIV section.

Wellcome Trust

Coronavirus (Covid-19): supporting global research and development
The Wellcome Trust is supporting COVID-19 research and development and working to make sure that any new vaccines, tests and treatments are mass-produced quickly and reach everyone who needs them.

National Congress of American Indians

Indian Country Resources: Coronavirus (COVID-19)
The National Congress of American Indians has developed a COVID-19 Resource Center.

Tribal Advocacy Materials for Implementing COVID-19 Funding
Presented here are the numerous letters NCAI and partner organizations have drafted and submitted to support tribal nations during the COVID-19 pandemic.

HIV/AIDS Clinical Trials Network COVID‑19 Studies

The HIV/AIDS Clinical Trials Networks have mobilized in response to the global pandemic and provided key support for COVID-19 vaccine and therapeutic research efforts. Studies and COVID-19 research collaborations in which the HIV/AIDS Clinical Trials Networks are involved are listed below.

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CoVPN

The COVID-19 Prevention Network (CoVPN) was formed by the National Institute of Allergy and Infectious Diseases (NIAID) at the US National Institutes of Health to respond to the global pandemic. Using the infectious disease expertise of their existing research networks and global partners, NIAID has directed the networks to address the pressing need for vaccines and monoclonal antibodies (mAbs) against SARS-CoV-2. 

ACTIV-2

The ACTIV-2 Outpatient Monoclonal Antibodies and Other Therapies Trial is a master protocol to evaluate the safety and efficacy of investigational agents for the treatment of symptomatic non-hospitalized adults with COVID-19. It begins with a phase II evaluation, followed by a transition into a larger phase III evaluation for promising agents.

Why is this study being done? 
To rapidly and efficiently evaluate multiple potential therapeutics for COVID-19 in an outpatient setting.

Who can join?

  • Ambulatory Adult (18 years or older)
  • Active SARS-CoV-2 infection <7 days prior to Entry
  • At least one typical COVID-19 symptom for <10 days prior to Entry, plus one the following symptoms present within 48 hours of entry:
    • Fever or feeling feverish, cough, shortness of breath at rest or with activity, sore throat, body or muscle pain, fatigue, headache, chills
  • Tailored per study agent requirements

Duration of study: 28 days of intensive follow-up, followed by limited follow-up through 24 weeks.

ACTG Press Release

HVTN 405/HPTN 1901

The NIH-funded HIV Vaccine Trials Network (HVTN) and HIV Prevention Trials Network (HPTN) have initiated their first clinical trial in response to COVID-19. The study, called HVTN 405/HPTN 1901, is underway at clinical trial sites across North and South America and will describe immune responses in study participants with a history of infection with SARS-CoV-2, the virus that causes COVID-19. HVTN 405/HPTN 1901 aims to enroll approximately 400 study participants aged 18 and older who tested positive for SARS-CoV-2 and have since recovered. Participants will have one required clinic visit and will have the option to participate in additional clinic visits two, four and twelve months after the initial visit. Each visit includes a blood draw and optional nasal sampling procedures. Individuals who still have symptoms of infection or asymptomatic individuals less than two weeks from the date of their last positive test will not be enrolled.

HIV/AIDS Clinical Trials Network Response to COVID‑19

Leveraging the infectious disease expertise, research infrastructure, and community partnerships of the existing HIV/AIDS research networks, the networks have responded to the need for vaccines, monoclonal antibodies, and therapeutics against SARS-CoV-2 infection. Announcements and public communications from the networks are found below:

COVID‑19 x HIV Scientific Updates

The Society of Infectious Diseases Pharmacists

COVID–19 Therapeutic Reviews

The SIDP have prepared brief, evidence-based educational reviews of potential pharmacotherapeutic treatment options for COVID‑19. Video presentations and handouts are updated regularly.

Milken Institute

COVID-19 Treatment and Vaccine Tracker

The Milken Institute is currently tracking the development of treatments and vaccines for COVID‑19. This tracker contains an aggregation of publicly-available information from validated sources.

Liverpool Drug Interaction Group

Interactions with Experimental COVID-19 Therapies

The LDIG has produced prescribing resources and other materials to assess drug interactions with experimental agents used in the treatment of COVID‑19

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FDA Actions

Emergency Use Authorization (EUA)
A record of vaccines, drug and biological therapeutic products, and medical devices authorized by the FDA under Emergency Use Authorization (EUA) can be found on the FDA website. The EUA authority allows FDA to help strengthen the nation’s public health protections against chemical, biological, radiological, and nuclear (CBRN) threats including infectious diseases, by facilitating the availability and use of medical countermeasures (MCMs) needed during public health emergencies. Background information about EUAs and records of authorizations issued by the FDA

The EUA is not intended to replace randomized clinical trials and facilitating the enrollment of patients into any of the ongoing randomized clinical trials is critically important for the definitive demonstration of safety and efficacy of COVID-19 vaccines and therapeutics.

EMA Actions

Treatments and Vaccines for COVID-19
A compliation of medicines authorised in the European Union (EU) to treat or prevent COVID-19, following a scientific evaluation by the European Medicines Agency (EMA). Additional details are provided on other potential treatments and vaccines that the EMA is evaluating or has provided support to during research and development.

Articles of Note

COVID-19 Outcomes Among Persons Living With or Without Diagnosed HIV Infection in New York State
Tesoriero JM et al., February 1, 2021 - JAMA Network Open

Key Takeaway: In this cohort study, persons living with diagnosed HIV experienced poorer COVID-related outcomes relative to persons living without diagnosed HIV; Previous HIV diagnosis was associated with higher rates of severe disease requiring hospitalization, and hospitalization risk increased with progression of HIV disease stage.

The interplay between HIV and COVID-19: summary of the data and responses to date
Brown LB et al., November 11, 2020 - Curr Opin HIV AIDS

Key Takeaway: Evidence to date does not suggest that people living with HIV (PLWH) have a markedly higher susceptibility to SARS-CoV-2 infection, with disparities in the social determinants of health and comorbidities likely having a greater influence. The majority of literature has not supported a higher risk for severe disease among PLWH in Europe and the United States, although a large, population-based study in South Africa reported a higher rate of death due to COVID-19. Higher rates of comorbidities associated with COVID-19 disease severity among PLWH is an urgent concern. COVID-19 is leading to decreased access to HIV prevention services and HIV testing, and worsening HIV treatment access and virologic suppression, which could lead to worsening HIV epidemic control. COVID-19 is threatening gains against the HIV epidemic, including the U.S. Ending the HIV Epidemic goals. The ongoing collision of these two global pandemics will continue to need both study and interventions to mitigate the effects of COVID-19 on HIV efforts worldwide.

The first 6 months of HIV-SARS-CoV-2 coinfection: outcomes for 6947 individuals
Johnston R, November 5, 2020 - Curr Opin HIV AIDS

Key Takeaway: The current review considers 6 months of data across geographic regions with a range of healthcare quality and access and ART regimens to generate a wider view of COVID-19 outcomes in PWH. Taken together, these studies indicate that HIV infection may be associated with increased risk of COVID-19 diagnosis, but comorbidities appear to play a larger role than HIV-specific variables in outcomes of COVID-19 among PWH. ART does not appear to protect from COVID-19 disease acquisition, progression or death.

Characteristics and outcomes of COVID-19 in patients with HIV: a multicentre research network study
Hadi YB et al., November 01, 2020 - AIDS

Key Takeaway: The authors studied clinical outcomes of COVID-19 infection in patients living with HIV (PLH) in comparison to non-HIV population. Crude COVID-19 mortality is higher in people living with HIV; however, propensity-matched analyses revealed no difference in outcomes, showing that higher mortality is driven by higher burden of comorbidities. Early diagnosis and intensive surveillance are needed to prevent a ‘Syndemic’ of diseases in this vulnerable cohort.

HIV infection and COVID-19 death: population-based cohort analysis of UK primary care data and linked national death registrations within the OpenSAFELY platform
Bhaskaran K et al., December 11, 2020 - Lancet HIV

Key Takeaway: We used UK primary care data from more than 17 million people linked to national death registrations to compare risk of COVID-19 death between people with and without HIV. People with HIV were at elevated risk of COVID-19 mortality compared with the general population without HIV, even after accounting for demographic characteristics, lifestyle-associated factors, and comorbidities. The association was particularly marked among people of Black ethnicity.

Outcomes of COVID-19 related hospitalisation among people with HIV in the ISARIC WHO clinical characterisation protocol UK protocol: prospective observational study
Geretti AM et al., August 11, 2020 - Clin Infect Dis

Key Takeaway: The authors compared the presentation characteristics and outcomes of people with and without HIV hospitalised with COVID-19 at 207 centres across the United Kingdom. The cumulative incidence of day-28 mortality was 25.2% in the HIV-positive group versus 32.1% in the HIV-negative group (p=0.12); however, stratification for age revealed a higher mortality among HIV-positive people aged below 60 years. The effect of HIV-positive status was confirmed in adjusted analyses (adjusted HR 1.49, 95% CI 0.99-2.25; p=0.06). Following additional adjustment for disease severity at presentation, mortality was higher in HIV-positive people (adjusted HR 1.63; 95% CI 1.07-2.48; p=0.02). In the HIV-positive group, mortality was more common among those who were slightly older and among people with obesity and diabetes with complications. The authors concluded that HIV-positive status may be associated with an increased risk of day-28 mortality following a COVID-19 related hospitalisation.

Immunologic characteristics of acute COVID-19 in people with HIV
Ho H et al., July, 2020 - 23rd International AIDS Conference, Abstract OABLB0104

Key Takeaway: "A related study showed that people with HIV had higher levels of inflammation, indicating that they are capable of mounting a strong inflammatory response to the new coronavirus and remain at risk for severe COVID-19 despite taking antiretroviral therapy (ART)."
Read Full Coverage by Liz Highleyman, NAM AIDSMAP

Clinical outcomes by HIV serostatus, CD4 count, and viral suppression among people hospitalized with COVID-19 in the Bronx, New York
Patel VV et al., July, 2020 - 23rd International AIDS Conference, Abstract OABLB0102

Key Takeaway: "People living with HIV spent a similar amount of time in hospital as HIV-negative COVID-19 patients and had a comparable death rate during the height of the outbreak in New York City, but they were more likely to be put on ventilators."
Read Full Coverage by Liz Highleyman, NAM AIDSMAP

COVID-19 in the largest US HIV cohort
Park LS et al., July, 2020 - 23rd International AIDS Conference, Abstract LBPEC23

Key Takeaway: "An analysis of the largest cohort of people living with HIV in the United States found that they were not more likely to contract the new coronavirus, and those who did so were not more likely to develop severe COVID-19."
Read Full Coverage by Liz Highleyman, NAM AIDSMAP

Incidence and Severity of COVID-19 in HIV-Positive Persons Receiving Antiretroviral Therapy
Del Amo J et al., June 26, 2020 - Annals of Internal Medicine

Key Takeaway: "HIV-positive patients receiving TDF/FTC have a lower risk for COVID-19 and related hospitalization than those receiving other therapies. These findings warrant further investigation in HIV preexposure prophylaxis studies and randomized trials in persons without HIV.”

Description of COVID-19 in HIV-infected individuals: a single-centre, prospective cohort
Vizcarra P et al., August 2020 - Lancet HIV

Key Takeaway: “HIV-infected individuals should not be considered to be protected from SARS-CoV-2 infection or to have lower risk of severe disease. Generally, they should receive the same treatment approach applied to the general population.”

Hospitalized patients with COVID-19 and HIV: a case series
Childs K et al., May 27, 2020 - Clin Infect Dis, online ahead of print

Key Takeaway: "Compared to our whole HIV outpatient cohort, those hospitalized with COVID-19 were more likely to be of black ethnicity (OR, 12.22 [95% CI, 1.62–92.00]) and to have lower median CD4 cell counts (395 vs 573, P = .03) (Supplementary Table 1). There was a trend toward more common use of protease inhibitor–containing antiretroviral regimens among those with COVID-19 (OR, 2.43 [95% CI, .94–6.29]). Our data indicate that, in contrast to earlier reports, there may be substantial morbidity and mortality from COVID-19 among PWH, even among those on suppressive ART. Black PWH appear to be at substantially increased risk of severe disease, and darunavir (or any other class of ART) does not appear to provide protection against moderate/severe COVID-19. If confirmed, African regions with a high prevalence of HIV infection.”

COVID-19 in Persons Living with HIV — What Do We Know Today?
Del Rio C, August 11, 2020 - NEJM Journal Watch

Key Takeaway: A review of eight published studies suggests the risk of SARS-CoV-2 infection and severe COVID-19 disease for persons with HIV is not due to immunosuppression but mostly due to underlying socioeconomic conditions and comorbidities. However, none of these studies came from Africa, where the largest percentage of people with HIV live. A preprint (not peer-reviewed) publication from the Western Cape in South Africa suggests that HIV increases the risk for COVID-19 mortality. The cohort study included close to 3.5 million people (16% HIV-positive) who live in the Western Cape, of whom 22,308 were diagnosed with COVID-19 and 625 (2.8%) died. HIV doubled the risk for COVID-19 mortality regardless of viral suppression. Current or previous tuberculosis also increased COVID-19 mortality.

COVID-19 in patients with HIV: clinical case series
Blanco JL et al., April 15, 2020 - Lancet HIV

Key Takeaway: Patients with HIV accounted for almost 1% of patients with COVID-19 who required admission to hospital in Barcelona. Infection was only observed in people younger than 50 years, who identified as MSM, and who have a COVID-19 clinical pictures resembling the general population. More studies of COVID-19 in patients with HIV are needed in the older MSM population, drug users, and heterosexual men and women in middle-income and lower-income settings. Second, implementing health education programmes is very important to explain that sex work-related activities in congregate settings could cause clusters of SARS-CoV-2 transmission. Third, investigation into the efficacy of ART regimens based on protease inhibitors in patients with COVID-19 in combined therapy in earlier stages of the disease is needed. Fourth, we did not give our patients remdesivir, the most active in-vitro and in-vivo antiviral drug against coronavirus to date, and is currently only available through clinical trials or for compassionate use. Finally, in advanced patients, we must ensure differential diagnosis and initial antimicrobial treatment to address pulmonary opportunistic infections presenting with similar clinical and radiological symptoms. By generating information such as we present here, the management and prognosis of patients co-infected with HIV and SARS-CoV-2 might be improved.

COVID‑19 Community Resources

Find resources on how to become a participant in clinical research, community engagement materials, important social media accounts to follow, webinars on COVID-19 and other useful information.

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COVID-19 CAB Coalition Partners

AVAC COVID-19 Advocates Advisory Board (CAAB)
The mission of the CAAB is to strategically engage civil society and community representatives to ensure the ethical, inclusive, efficient, and accelerated advancement of research and development for urgently needed interventions to combat COVID-19, as well as global access to proven interventions, especially among historically vulnerable and disenfranchised populations, countries, and communities.

Social Media Accounts to Follow

ACTIV-2/RISE ABOVE COVID
Facebook
Instagram

CoVPN
Facebook
Instagram
Twitter

COVID‑19 Behavioral and Mental Health Care Resources

Behavioral insights for people with COVID-19 as well as those living with HIV.

Survey Tools, Interview Guides, and Indexes

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NIH

Since the COVID-19 pandemic began, researchers with existing longitudinal cohorts and survey samples have been developing and fielding new survey items assessing various COVID-19 specific domains such as symptoms, knowledge and attitudes, adherence to various mitigation behaviors, social impacts, and economic impacts. Efforts to standardize or harmonize COVID-19 survey items, however, did not appear feasible given the urgency to field items as early as possible during the pandemic.

To minimize the proliferation of one-off survey items, encourage comparisons across samples, and facilitate data integration and collaboration, a trans-NIH working group co-led by the National Institute on Aging (NIA) and the Office of Behavioral and Social Sciences Research (OBSSR) worked to make existing COVID-19 survey items and investigator contact information available in a survey item repository. Two NIH-supported survey item platforms have made this expanding list of survey items available as a resource for researchers interested in assessing COVID-19 specific domains.

  • NIH Public Health Emergency and Disaster Research Response (DR2): The National Institute of Environmental Health Sciences (NIEHS) and the National Library of Medicine (NLM) host the DR2 site which now includes a list of COVID-19 surveys and the domains assessed in the surveys. In addition to this COVID-19 list, DR2 provides a wide array of data collection tools and resources used in other public health emergencies and disasters, providing researchers with a rich repository of survey and other measurement tools that are applicable to the COVID-19 pandemic. 
  • PhenX Toolkit: The PhenX Toolkit now includes a list of COVID-19 related measurement protocols drawn from the surveys listed in DR2. These COVID-19 survey protocols have not been vetted as per the PhenX consensus process but are made available for other researchers to consider, and to test as needed, before incorporating in their research studies. The PhenX Toolkit, funded by the National Human Genome Research Institute (NHGRI) and other NIH Institutes and Centers, has a large collection of well-established and vetted measurement protocols suitable to incorporate into studies involving COVID-19. 

Researchers addressing COVID-19 questions, whether population-based or for clinical research, are encouraged to consider these COVID-19 specific survey item repositories and select existing survey items or protocol modules currently being fielded. Researchers with additional survey items about to be fielded are encouraged to make them public for other researchers to consider by submitting the survey to NIHCOVID19Measures@nih.gov.

ATN COVID-19 Questionnaire (Draft​)

Provided by the Adolescent Medicine Trials Network for HIV/AIDS Interventions (ATN). Revised April 8, 2020.

What is the goal of these questions?

  • Important to know how the standard of care is being affected by the pandemic.
  • Is COVID-19 affecting the specific behaviors we are looking at for our study outcomes?
  • How much of the effect is biasing away from the null?
  • This would give information into the dips or rise that we may see into different behaviors.

View Questionnaire

COVID-19 Exposure and Family Impact Survey (CEFIS-19)

A group of researchers from Nemours, CHOP and Cincinnati have developed a questionnaire designed for insertion into ongoing and new child health studies where aspects of the COVID-19 pandemic may impact study findings. The COVID-19 Exposure and Family Impact Survey (CEFIS-19) is in English and Spanish. There are also have REDCap versions. While designed for research, there may also be clinical applications. There is no charge for use, but it is requested that you register your work as the survey is covered by the SAMHSA-funded Center for Pediatric Traumatic Stress in the National Child Traumatic Stress Network. The Healthcare Toolbox has related COVID-19 materials that are updated and, in some cases, newly developed.

Shared by Anne E. Kazak, Ph.D., ABPP, Director, Center for Healthcare Delivery Science, Nemours Children’s Health System, Co-Director, Center for Pediatric Traumatic Stress (www.healthcaretoolbox.org), Professor, Department of Pediatrics, Thomas Jefferson University, Editor-in-Chief, American Psychologist.

COVID-19 Interview Items for Vulnerable Populations

Compiled by the Center for Drug Use and HIV | HCV Research (April 11, 2020). This site includes the following items:

  • Gwadz Qualitative Interview Guide
  • Harkness, A. (2020). The Pandemic Stress Index. University of Miami
  • Kalichman Covid-19 Assessment
  • Bennett and Elliot Qualitative Interview Guide
  • Stanford
  • COVID-19 Pandemic Social Distancing Event Items
  • N2 COVID-19 Check-in Survey Items (phone interview)
  • Benoit OTP Staff Survey
  • Benoit OTP Patients Focus Group Guide
  • Benoit People Who Use Drugs and Not Currently in Treatment Focus Group Guide
  • ATN
  • University of Miami School of Nursing and Health Studies Center of Excellence for Health Disparities Research: Measures Library - COVID-19
  • PhenX Toolkit COVID-19 Protocols
  • National Library of Medicine Disaster Research Resource
  • Gwadz Qualitative Interview Guide

View Interview Items

COVID-19 Quantitative Questionnare

This COVID-19 Quantitative Questionnaire was developed for MTN042/MTN-043, two trials in sub-Saharan Africa with pregnant (MTN-042/Deliver) and breastfeeding (MTN-043/B-protected) women.

View Questionnaire

The Pandemic Stress Index

The Pandemic Stress Index Survey
The Pandemic Stress Index is a measure of behavior changes and stress related to the COVID-19 pandemic developed at the University of Miami. The survey is available in Spanish, Turkish, Italian, Mandarin, Creole, Arabic, Portuguese, Lithuanian, and Greek.

Learn More About the Survey

Survey Tool and Guidance | WHO European Region

This document provides guidance to Member States in the WHO European Region that wish to conduct behavioural insights studies related to COVID-19. The COVID-19 pandemic outbreak is placing an overwhelming burden on health systems and authorities to respond with effective and appropriate interventions, policies and messages. A poorly timed and managed pandemic response or transition phase can threaten the gains collectively achieved. The pandemic and its restrictions may have affected mental and physical well-being, social cohesion, economic stability as well as individual and community resilience and trust. In this complex context, understanding how, why and the context in which humans and communities respond allows to:

  1. anticipate unwanted scenarios and initiate mitigating measures; and
  2. implement pandemic response measures that are better informed, situated, accepted and thus more effective.

Population surveys can explore perceptions, acceptance of restrictions, mental and physical health, behaviours, information needs, misperceptions and more.

View Survey Tool and Guidance PDF

Mental Health Resources and Articles

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Online Resources

Massachusetts General Hospital Psychiatry Department
The Massachusetts General Hospital Psychiatry Department has an excellent set of comprehensive collated set of materials for COVID mental health for the general public

University of Miami Center for HIV and Research in Mental Health (CHARM)
The University of Miami Center for HIV and Research in Mental Health (CHARM) also has an excellent list of COVID-19 Mental Health Resources.

WHO Comprehensive Mental Health Action Plan 2013-2020
The WHO Comprehensive Mental Health Action Plan 2013-2020 is the global plan that sets out the indicators that all WHO Member states have agreed to deliver in order to improve mental health for all.  This plan will be updated over the course of this year and Ministers of Health will approve the new plan for 2021-2030 in May 2021 at the World Health Assembly. 

In the coming weeks and months, the WHO will be leading discussions with governments at regional and country level on the new plan and with stakeholders more broadly. The WHO is also holding two periods of online consultation on the updates to the plan. 

Additional WHO Resources:
Mental health and psychosocial considerations during the COVID-19 outbreak
Social stigma associated with COVID-19

Blogs and Articles

Dealing with Stress, Anxiety, and Grief during COVID-19 
NIH Director's Blog - April 7, 2020

From Dr. Francis Collins’ NIH Director’s Blog. This is a discussion with Dr. Joshua Gordon, Director of NIH’s National Institute of Mental Health, about how physical distancing can affect our mental well-being during the COVID-19 pandemic

The Burden of COVID‐19 in People Living with HIV: A Syndemic Perspective
Shiau S et al., August 2020 - AIDS Behav.

Summary: The emergence of the novel coronavirus disease known as COVID-19 creates another health burden for people living with HIV (PLWH) who face multiple morbidities and may be at heightened risk for severe physical health illness from COVID- 19. Our abilities to address these morbidities in PLWH must be considered alongside the socially-produced burdens that both place this population at risk for COVID-19 and heighten the likelihood of adverse outcomes. These burdens can affect the physical, emotional, and social well-being of PLWH and interfere with the delivery of effective healthcare and access to HIV treatment. We posit that a syndemic framework can be used to conceptualize the potential impact of COVID-19 among PLWH to inform the development of health programming services. 

Characterizing the Impact of COVID-19 on Men Who Have Sex with Men Across the United States in April 2020
Sanchez TH et al., July 1, 2020 - AIDS Behav.

Summary: The COVID-19 pandemic is reinforcing health inequities among vulnerable populations, including men who have sex with men (MSM). We conducted a rapid online survey of COVID-19 related impacts on the sexual health of 1051 US MSM. Many participants had adverse impacts to general wellbeing, social interactions, money, food, drug use and alcohol consumption. Half had fewer sex partners and most had no change in condom access or use. Some reported challenges in accessing HIV testing, prevention and treatment services. Compared to older MSM, those 15–24 years were more likely to report economic and service impacts. While additional studies of COVID-19 epidemiology among MSM are needed, there is already evidence of emerging interruptions to HIV-related services. Scalable remote solutions such as telehealth and mailed testing and prevention supplies may be urgently needed to avert increased HIV incidence among MSM during the COVID-19 pandemic era.

Laboratory Memos and Guidelines

The COVID-19 pandemic has impacted the operations, capacity, and processes among laboratories affiliated with the HIV/AIDS Clinical Trials Networks. Announcements and guidance specific to labs are found below.

Webinars

Webinars relating to the COVID-19 pandemic and the intersection of COVID-19 with HIV.

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COVID-19 Webinars

HANC-facilitated COVID-19 Webinars
Find a repository of webinars hosted by the COVID-19 CAB Coalition.

NIH Clinical Trials to Test Antibody Treatments in COVID-19 Patients
Dr. Francis Collins and Dr. Anthony Fauci discuss the ACTIV-2 study launch and questions related to monoclonal antibodies.

Rise Above COVID: Introducing the ACTIV-2 Study (September 22, 2020)
This webinar introduces the ACTIV-2 Study, which will investigate possible treatments for mild to moderate COVID-19 in people 18 years old and up. Hosted by the University of Washington AIDS Clinical Trials Unit.

Learning from Historic Vaccine Research & the Latest on the mRNA-1273 Candidate (August 25, 2020)
AVAC held a webinar presentation and discussion with Dr. Barney Graham, the Deputy Director of the NIH’s Vaccine Research Center (VRC). Dr. Graham reviewed the rapid development timeline for COVID-19 vaccines and explored some of the recent and historic vaccine research developments that are being applied to this challenge. He also provided a specific update on the mRNA-1273 vaccine—a vaccine developed by Moderna and the NIH—which is undergoing testing in a Phase III clinical trial launched last month.

Recording and Slides: YouTube / Dr. Graham's Slides

COVID-19 and HIV Webinars

AVAC HIV Advocates' Update on COVID-19 (March 23, 2020)
AVAC was joined by Dr. Carl Dieffenbach, Director of the Division of AIDS (DAIDS) at the NIH, and other partners, to answer questions about what we do and don’t know about COVID-19 and HIV, how to track research developments on the HIV front, what this new pandemic might mean for ongoing HIV research, and how the HIV community can contribute to the fight against COVID-19.

COVID-19 & HIV Full Meeting (March 24, 2020)
The University of Washington AIDS Clinical Trials Unit’s Community Advisory Board (UW ACTU CAB) held an online meeting focused on the COVID-19 pandemic. Dr. Rachel Bender Ignacio, Associate Director of the UW ACTU, presented and her excellent slides can be downloaded here.

COVID-19 & HIV Update: Impact on Communities & HIV/AIDS Clinical Research ​(April 2, 2020)
​The Office of HIV/AIDS Network Coordination (HANC) hosted a webinar featuring Dr. Carl Dieffenbach​, Director of the Division of AIDS (DAIDS) at the National Institute of Allergy and Infectious Diseases; Dr. Sarah Read, Deputy Director of the DAIDS; Manizhe Payton, Director of the Office of Clinical Site Oversight (OCSO) at DAIDS; and Dr. Jeffrey Schouten, HANC Director, in an effort to inform network stakeholders and community about the impact of COVID-19 on HIV research.

COVID-19: A clinical update for HIV care providers (April 1, 2020)
Hosted by the American Academy of HIV Medicine (AAHIVM) and Association of Nurses in AIDS Care (ANAC)). 

Finding the Middle Ground: Managing Stress and Anxiety During the COVID-19 Crisis (May 7, 2020)
Dr. Steven Safren and Dr. Deborah Jones Weiss from the University of Miami discuss stress and anxiety management strategies for providers during the COVID-19 epidemic. 

Discussion with Jon Cohen on HIV and COVID-19 Vaccine Research (May 13, 2020)
AVAC hosted an excellent webinar with Science Magazine’s Jon Cohen. Jon talked about the fast-growing pipeline of vaccine candidates for COVID-19, how COVID-19 research is evolving and building on HIV vaccine research and more. The recording and terrific slides have been posted by AVAC.

International AIDS Society (IAS) Webinars
The International AIDS Society (IAS) is organizing a series of webinars on the topic of COVID-19 and HIV to discuss the pandemic and its impact on people living with HIV. Through these webinar sessions, the IAS would like to provide an opportunity for discussion around the latest science, in addition to sharing learning and best practices in relation to COVID-19 and HIV between countries at different stages of the pandemic, especially in lower- and middle-income countries.​ View the webinars here​

Update on COVID-19 For NIAID HIV/AIDS Community Advisory Boards (June 10, 2020)
Dr. Anthony Fauci, Director of NIAID, NIH gave a talk to HIV network CABS. The recording is available on YouTube. View his excellent slide presentation

Follow-up Discussion with Dr. Dieffenbach on COVID for NIAID CABs (June 23, 2020)
Steve Wakefield moderated a webinar discussion with Dr. Carl Dieffenbach.

COVID-19 and People Living with HIV (June 18, 2020)
The University of Washington’s AIDS Clinical Trials Unit Associate Director, Dr. Rachel Bender Ignacio, presented a webinar on COVID-19 and People Living with HIV to the ACTG’s Global Community Advisory Board.

Mental Health and Stress Management

Caring for Yourself & Others during the Covid-19 Pandemic: Managing Healthcare Workers’ Stress
Patricia Watson, PhD, National Center for PTSD - March 24, 2020

Patricia Watson, PhD, of the National Center for PTSD discusses ways that healthcare workers can manage stress — theirs and others’ — as we face the ever-changing circumstances of the COVID-19 pandemic.

Regulating emotions & building resiliency in the face of a pandemic
Luana Marques, PhD, Harvard Medical School - April 1, 2020

This webinar series was created to support the students and staff of the Harvard Medical School community, yet the lessons will be broadly applicable to all who are feeling the emotional strain of this unprecedented crisis.

Managing Anxiety Related to Taking Care of Patients during the COVID-19 Pandemic
Cheryl Gore-Felton, PhD, Debra Kaysen, PhD and Mickey Trockel, MD, PhD., Stanford Medicine - April 3, 2020

The Stanford Medicine COVID-19 Support Series was created out of recognition of the emotional dimension of the COVID-19 pandemic. This webinar addresses strategies that healthcare professionals may utilize to manage their anxiety related to caring for patients with COVID-19 infection.