COVID-19 and People with HIV

Content From: HIV.gov•Updated: May 16, 2024•9 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 help protect yourself and others from health risks caused by COVID-19 and many other types of respiratory viruses, including flu and respiratory syncytial virus (RSV). Read CDC’s updated Respiratory Virus Guidance for practical recommendations and information to help you lower the health risks posed by a range of common respiratory viral illnesses.

Feeling sick? Testing for COVID-19 and other respiratory viruses is a prevention strategy that you can choose to assist in making decisions to protect yourself and others. Testing can help you 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 and respiratory viruses. If the test is 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. Learn about other key times to get tested.

Need a test? You can buy COVID-19 self-tests online or in pharmacies and retail stores. Private health insurance may reimburse the cost of purchasing self-tests. You can also contact your local health department to find out about the availability of free tests in your area.

COVID-19 treatment. If you test positive for COVID-19 and are more likely to get very sick, COVID-19 treatments are available that can reduce your chances of hospitalization and death. Contact a healthcare provider right away or visit a Test to Treat location to see if you’re eligible for treatment, even if your symptoms are mild right now. Test to Treat partners include some of the nation’s largest pharmacy chains. Don’t delay: COVID-19 treatment must be started within 5-7 days after you first develop symptoms 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 pre-exposure prophylaxis (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 with COVID-19 vaccines for their age group. According to CDC, here’s what you need to know:

CDC recommends the 2023-2024 updated COVID-19 vaccines: Pfizer-BioNTech, Moderna, or Novavax, to protect against serious illness from COVID-19.
Everyone aged 5 years and older should get 1 dose of an updated COVID-19 vaccine to protect against serious illness from COVID-19.*
Children aged 6 months–4 years may need multiple doses of COVID-19 vaccine to be up to date, including at least 1 dose of updated COVID-19 vaccine.
People who are moderately or severely immunocompromised (have weakened immune systems) may get additional doses of the updated COVID-19 vaccine. This includes people with advanced or untreated HIV.
People aged 65 years and older who received 1 dose of any updated 2023-2024 COVID-19 vaccine (Pfizer-BioNTech, Moderna or Novavax) should receive 1 additional dose of an updated COVID-19 vaccine at least 4 months after the previous updated dose. For more Novavax information, click or tap here.
COVID-19 vaccine recommendations will be updated as needed.
People who are up to date have lower risk of severe illness, hospitalization, and death from COVID-19 than people who are unvaccinated or who have not completed the doses recommended for them by CDC.

* People aged 12 years and older who have not previously gotten any COVID-19 vaccine doses and choose to get Novavax should get 2 doses of updated Novavax vaccine to be up to date.

Learn more about CDC's recommendations.

Vaccine safety. COVID-19 vaccines are safe for people with HIV and people with HIV were included in vaccine clinical trials. Learn more about what federal agencies are doing to make sure COVID-19 vaccines are safe and effective.

There is no evidence that COVID-19 vaccines interfere with ART to treat HIV or PrEP to prevent HIV. 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. This definition of Long COVID was developed by the U.S. Department of Health and Human Services (HHS) in collaboration with CDC and other partners.

There is no 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.

Studies have shown that some groups of people may be affected more by Long COVID. This includes people who had underlying health conditions prior to COVID-19. Health inequities may also put some people from racial or ethnic minority groups and some people with disabilities at greater risk for developing Long COVID. However, scientists are still working to understand which people or groups of people are more likely to have Long COVID, and why. Some of this research is being coordinated by NIH’s RECOVER initiative Exit Disclaimer.

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 for people with HIV and the health care providers and organizations who work with them. Information is regularly being updated as we learn more in this evolving situation.

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.
People Who Use Drugs or Have Substance Use Disorder (July 2021)—This page provides COVID-19 information for people who use drugs or have substance use disorder and their loved ones.
PrEP During COVID-19 (May 2020)—This CDC guidance, issued in 2020, addressed the provision of PrEP for HIV during the COVID-19 epidemic.

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 who are responding to COVID-19.

National Institutes of Health (NIH)

COVID-19 Treatment Guidelines-Special Considerations for People with HIV—This section of NIH’s COVID-19 treatment guidelines discusses the prevention and management of COVID-19 in people with HIV. (Note: The final update of the COVID-19 Treatment Guidelines was on February 29, 2024. PDFs of the Guidelines can be downloaded until August 16, 2024, when the website will be shut down.)
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, including the impacts on those with pre-existing mental and substance use disorders and racial/ethnic minorities.
SAMHSA.gov/coronavirus—This site provides guidance and resources to assist individuals, providers, communities, and states.

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

Health+ Long COVID Report (Nov 2022)—This report brings the experiences of people with Long COVID to the forefront in defining solutions.
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, webinars, and other COVID-19 resources for the grantees of HUD’s Housing Opportunities for People with AIDS (HOPWA) Program.