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Is COVID-19 More Harmful To People With HIV? The Research Isn't Clear

Medical professional wearing gloves uses a syringe to give vaccine to a patient
Dr. John Carlo says the COVID-19 vaccination has not worked against the medication used for HIV. He urges people living with HIV to get the COVID vaccine.

One recent study concluded people living with HIV were more likely to face severe illness and to die if hospitalized than others infected. Results from another recent study found no greater risk.

KERA's Sam Baker talked about this with Dr. John Carlo, the CEO of Prism Health North Texas, a local nonprofit HIV/AIDS service organization.


This interview was lightly edited for clarity.

About The Difference In Study Results:

There is certainly a reason why we would suspect somebody living with HIV would have a more severe coronavirus infection.

The HIV virus attacks our immune cells that would be used to fight off any type of infection, including a coronavirus infection. So it's certainly possible that we would see this as a risk factor.

However, some medications we use to treat HIV may actually have antiviral properties that actually could protect somebody, against a more severe coronavirus infection. In fact, very early on we were studying some anti-HIV medications that may have had some potential ability to also treat coronavirus infections.

So there's a lot of potential reasons why, in both directions, there certainly could be either an increased risk or no increased rate.

Higher Vaccine Priority For People With HIV

If you look at HIV as an immune-compromising condition, then somebody that has not fully treated HIV is susceptible to secondary infections. So I think it's entirely plausible to put somebody living with HIV in the same category of other high-risk medical conditions that could receive a stronger benefit from that coronavirus vaccine. So we think that makes sense.

The other good news we've seen so far is the vaccine does work in people living with HIV. However, we do believe if you are untreated for HIV, you may have less of an immune system to ramp up with the vaccine. So again, we go back to making sure the HIV is completely treated as best it can be. And we add that vaccine as well.

COVID Vaccine Vs. HIV Medication:

We have not seen any effect of a coronavirus vaccine limiting the HIV treatment capabilities. Really for all the vaccines that we provide for our patients living with HIV, none have affected the ability of the medications to work.

How People With HIV Should Move Forward After The Studies

When we talk about health for our patients, it's more than just taking the medications and saying that's all you need to do.

We want to keep the HIV virus completely suppressed, which we can do with the great medications we have. We also need to treat all of the other medical conditions that would put a patient at higher risk for coronavirus infection:

  • High blood pressure
  • Diabetes
  • Kidney disease
  • Lung disease

If we can do all of those things, I think we are really setting up our patients to have great protection against coronavirus with the last caveat, of course, getting the vaccine.

Even With The Delta Variant?

It will make matters worse, unfortunately, given how infectious the Delta variant is. The vaccine is still protective, still the right thing to do today.

One thing we will have to look at going forward is people living with HIV have immunocompromised conditions. So, the vaccine may not last as long as other people. So, we'll need to look at that carefully, but right now the best advice is to continue to get that vaccine as soon as possible.


COVID-19 Is Especially Risky for People With H.I.V., Large Study Finds

COVID-19 Severe Risks Not Significant in People with HIV

What to Know About HIV and COVID-19 (

Got a tip? Email Sam Baker at You can follow Sam on Twitter @srbkera.

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Sam Baker is KERA's senior editor and local host for Morning Edition. The native of Beaumont, Texas, also edits and produces radio commentaries and Vital Signs, a series that's part of the station's Breakthroughs initiative. He also was the longtime host of KERA 13’s Emmy Award-winning public affairs program On the Record. He also won an Emmy in 2008 for KERA’s Sharing the Power: A Voter’s Voice Special, and has earned honors from the Associated Press and the Public Radio News Directors Inc.