Navigating ARV Adherence during the COVID-19 Pandemic: My Story

A stigma that has led to hesitancy that resulted in many unnecessary deaths. 

We’ve all heard stories of the difficulties and tragedies that people living with HIV have been put through. These are stories that can no longer be told, or even experienced by anyone who is living with HIV.

The COVID-19 pandemic was a trying time for every single person in the world. It brought about many challenges people had never experienced. Adjusting to these challenges, although eventually possible, was initially very difficult. 

For people living with HIV the challenges that came with the pandemic had a retraumatizing effect.

For someone like Cindy, a young person living with HIV in South Africa, the realities were not in her favour. In a country where adolescent and young women infected with HIV account for 23% of the global average. 

Nearby clinics often experience ARV treatment stockouts and the enormity of ensuring personal ARV treatment adherence quadrupled for people living with HIV.   

In the beginning of the pandemic, the possibility of contracting SARS-COV-2 (COVID-19) was a terrible reality for everyone. That, coupled with living with HIV, was an even bigger fear for Cindy. It brought back the trauma that was brought about by the stigma that came with living with HIV. Our country’s lockdown restrictions added to this dark reality. Accessing treatment would make the mountainous task of getting treatment before seem like a molehill.

It is not all doom and gloom. As time has progressed there are things we have come to learn. Many of the fears that had a grip on us at the start of the pandemic have been out to rest.. Here’s what we know so far:

• There is nothing to suggest getting a COVID-19 vaccine will affect your antiretroviral treatment in any way. 
• South Africa’s progress towards 90-90-90 targets is well underway with 92% people aware of their status, 75% on treatment and 92% living with a suppressed viral load.
• According to a PEPFAR study presented to the 11th International AIDS Society Conference on HIV Science (IAS 2021) Fewer people living with HIV in six sub-Saharan African countries experienced interruptions to their HIV treatment during and after COVID-19-related lockdowns than before the pandemic hit.
• Scientists at the African Health Research Institute have found that SARS-CoV-2 mutations can arise in a few people with advanced or untreated HIV, not within people living with HIV who are successfully managing their viral load through ensuring they are adhering to their ARV treatment regimen. 

When it comes to treatment and people living with HIV adherence has been key. South Africa has the world’s largest ART programme, which has undergone further expansion with the implementation of ‘test and treat’ guidelines.

During the pandemic there was one more huge success. The FDA approval of the first Injectable Treatment for HIV Pre-Exposure Prevention (PrEP). This is a long-acting formula that is a step forward and a valuable addition towards HIV prevention.

Although the journey of living with HIV hasn’t been easy for people like Cindy, living with HIV is easier than ever before, even during a pandemic.

Between the combination of healthcare systems that continuously do their best to ensure treatment adherence and the advancements in medical research, there is light and hope.