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HIV in the Age of Coronavirus: Understanding the Facts

April 19th, 2020

Written by:  Dimitri Joseph Moise

 

As the coronavirus crisis continues without a seemingly near-end in sight, you might be a person living with HIV wondering if you should be more concerned. Sensationalized media can leave you with many questions, and you might be questioning if the information you’re reading is even true.

I had the chance to sit down and chat with Dr. David Malebranche, M.D., M. P. H., Associate Professor of Medicine and Medical Director of Student & Employee Health at Morehouse School of Medicine. Keeping on the pulse of what’s happening day-to-day, here’s what Dr. Malebranche had to say:

 

- Are people living with HIV at a greater risk of contracting Covid? What can be said for a person who is newly diagnosed with a low cd4 count and resistant to medication?

 

“People living with HIV will be at greater risk if not on medications, with lower T-cell counts, and if not virally suppressed. For someone newly diagnosed with a low T-cell count, they need to get in care and on meds as soon as possible, and take all the precautions that everyone else is (physical distancing, washing hands, not touching face, cleaning off surfaces, masks, etc).”

 

- What can a person living with HIV do to protect themselves during this time?

 

“Aside from everything mentioned so far, people living with HIV should be getting in contact with their doctors about ensuring 30 to 90 days of refills are on board. I would also recommend doing telehealth visits for nonurgent follow-ups. Some other important things to note include:

- Mental health attention. Whether that means therapy, working out, communicating with friends, or prayer. Please pay attention to your mental health.

- Sleep,

- exercise,

- healthy eating,

- avoiding smoking, drug use, and heavy drinking.

 Basically, make sure to do all of the things one would typically do to help boost their immune system if they are diagnosed with HIV. Do all of that, and be extra careful about washing hands, having close contact with others, and any other exposure that could get you in touch with coronavirus.”

 

- For any essential workers living with HIV, what can be done to help them protect themselves (in transit or at work)?

 

“Practice physical distancing as much as you can. If you can't do that, or if you want to add to physical distancing, use masks to help. Carry hand sanitizer. Be extra cautious about touching hands to face. I think, especially as we ease into people going back to work, particularly with essential workers -- since tests aren't being done as much as they should be, these measures are our best defense.”

 

- In the media, we are hearing nonstop that COVID-19 is disproportionately affecting Black and Latinx folks. Why is this affecting communities of color and poor people at higher rates?

 

“The answer is simple: decades and hundreds of years of institutional, education, systematic racism in terms of housing, job opportunities, guidelines, public health infrastructure. These inequities are conscious, and have been reinforced in areas where Black and brown folks live, and where poor folks of other races/ethnicities live. If systems, neighborhoods, and environments are not on equal footing, and you drop a new virus in the mix, there's going to be inequities in health outcomes. Add to that political and religious brainwashing, spreading of conspiracy theories, and other misinformation -- this adds to the distrust of medical and public health initiatives/messaging due to a history of experimentation and exploitation of Black and brown bodies, it's a perfect storm for worsening racial disparities.”

 

- What has COVID-19 shown to us, in terms of our societal, economic, and health structures? How can we fix this?

 

“This virus has shown how woefully unprepared we were for a pandemic. When you have a President who decimates the pandemic team his predecessor created, "just because," then states the virus is a "hoax," then delays acting based on public health recommendations for weeks - this is what you get. We can fix this in November by voting. We need leadership in this country that is actually serious about helping ALL American people.”

 

- What is this pandemic teaching us about each other? How do we move forward?

 

“For me, it's teaching me that we have gotten to the point where facts don't matter, and science doesn't matter. We have exploited America's "me first" cultural mentality - this is a lot of the reason why the country was slow to catch up to warnings, and will likely be why this pandemic will drag longer than it should. I have also seen profound examples of human beings loving each other and showing compassion. So in many ways it has exposed the some of the worst in American humanity, but also brought to the surface some really amazing things about humankind.”

 

- How do you visualize our “new normal?”

 

“Ah -- I hate that phrase. I don't think there will be a ‘new normal.’ I think society will have to shift, learn, and adapt to changing times and changing threats. One thing that is good from all of this is that hopefully people will stop being so cavalier about not washing hands after using the bathroom, crowding in someone else's space, etc. I think this will actually be a good thing for controlling other potential infectious epidemics, like the flu and others. I also think that this leads us into new territory where eating out, teaching, medicine and many other fields - will be changed forever and moved towards more efficiency, more technology, and less interpersonal interaction. Whether that is a good or bad thing will remain to be seen.”

 

 

David J. Malebranche, MD, MPH, is a board-certified Internal Medicine physician and public health official with expertise in men's health, student health, racial inequities in medicine, and LGBT health, as well as the prevention and treatment of HIV and Sexually Transmitted Infections (STI). He is currently an Associate Professor of Medicine and the Medical Director of Student & Employee Health at Morehouse School of Medicine. Dr. Malebranche is an experienced qualitative HIV behavioral prevention researcher who has completed several studies on sexual health among Black men of diverse sexualities.

Dr. Malebranche has published over 50 articles in medical and public health journals such as The Annals of Internal Medicine, The American Journal of Public Health, JAMA, and the Lancet, He is known as a dynamic speaker worldwide and has appeared in documentaries on CNN, ABC News Primetime, TV One, and Black Entertainment Television (BET) for his expertise on HIV in the Black community. Dr. Malebranche served as a member of the President’s Advisory Council on HIV/AIDS (PACHA) from 2006 – 2008 and was the HIV clinical expert on WebMD from 2010 - 2012. He also appears in the video series #AsktheHIVDoc, which promotes HIV education on prevention and treatment, and Revolutionary Health, a YouTube health series that is part of The Counter Narrative Project, an advocacy organization for Black same gender loving men. In 2015, Dr. Malebranche published his first book, a memoir about his father entitled Standing on His Shoulders. He currently resides in Atlanta, Georgia. Instagram: @dmalebr