Living with HIV

Partner Notification Program for the Newly Diagnosed

When an individual is newly diagnosed with HIV, there are a variety of services available that are intended to ease any uncertainty or anxiety that they may feel. Partner Notification is one of these services and is provided by highly-skilled Disease Intervention Specialists at the Iowa Department of Public Health. These individuals can assist you with telling your previous partners that they may have been exposed to HIV. If you aren’t comfortable telling your previous partners yourself, they can also notify them anonymously on your behalf. Staff never share your information with people. They only notify them of a possible exposure and offer voluntary HIV testing services to the individuals you name.

HIV is a virus spread through certain body fluids that attacks the body’s immune system, specifically the CD4 cells, often called T cells. Over time, HIV can destroy so many of these cells that the body can’t fight off infections and disease. These special cells help the immune system fight off infections. Untreated, HIV reduces the number of CD4 cells (T cells) in the body. This damage to the immune system makes it harder and harder for the body to fight off infections and some other diseases. Opportunistic infections or cancers can occur when the immune system is so weak that it can no longer function properly. Learn more about the stages of HIV at this page of the HIV.gov website.

Treatment is available to help you manage HIV.  HIV medications work in different ways to reduce the amount of HIV in your body, improving your health and reducing the chance of transmission to others. Antiretroviral Therapy (ART) is a combination of medications (called a regimen) used to treat HIV. These medications are effective and many people living with HIV work with their doctors to find a regimen that is easy to take. Some medications may have side effects. Working with your case manager and doctor is an important step to finding the right medications for you. For more information about HIV treatment please check out the AIDS Info HIV Treatment fact sheet.

How Can I Get HIV Medication Assistance?

Assistance may be available to help with the cost of medications through the AIDS Drug Assistance Program. Contact your nearest Ryan White Part B case manager for more information about the programs available and eligibility guidelines.

How Do I Talk About My HIV Status?

If you are a person living with HIV, telling others about your status is a very personal decision. The word “disclose” is used to describe the act of sharing your HIV status with someone. It can be hard to decide who you are going to disclose your status to and when the right time is to share it. Often times there are many pros and cons to disclosing your HIV status with others. 

Confidential Partner Notification Program

You are not required to share your status with everyone. There may be some people you’re considering disclosing to—including your medical provider, sexual partners, and/or people you substance use equipment with. Disclosing your status with your medical provider will help you get access to the medical care you need. Disclosing your status to sexual or needle-sharing partners can be difficult but could help prevent these people in your life from acquiring HIV. The confidential Partner Notification Program through the Iowa Department of Public Health is made up of trained professionals who can help you notify your partner(s). This is done confidentially, without sharing the information about you or when the exposure may have occurred.  

Your Ryan White case manager can also be a great resource when you are thinking about telling others about your status. Case managers have a lot of experience helping people develop individualized plans focused on disclosure.

The Ryan White Program in Iowa is a comprehensive system of services available across the state that serve eligible Iowans living with HIV. Services include primary medical care and essential support services through the Ryan White Part B and Part C Programs.

The Ryan White Part B Program provides case management, support services, and medication assistance.The Ryan White Part B Program is designed to improve access and quality of services for Iowans living with HIV. A case manager will provide support and navigation to assist with a variety of needs including access to medical care, medications, insurance coverage, mental health services, transportation, stable housing and much more. The Ryan White Part B Program is administered by the Iowa Department of Public Health, Bureau of HIV, STD, and Hepatitis.

The Ryan White Program provides a variety of services to help HIV-positive Iowans across Iowa to live a healthy life. Services include access to medical care, medication, mental health care, oral health care, transportation, and much more. Use our service locator to find services near you.

COVID-19 Information for Persons Living with HIV in Iowa 

The impact of COVID-19 on people with HIV is not known. Current evidence indicates that the risk of severe illness increases with age and with certain chronic medical problems. Although people with HIV who are on treatment with a normal CD4 T-cell count are not thought to be at an increased risk of serious illness, many people with HIV have conditions that increase their risk:

- Older age - half of people living with HIV in Iowa are over 50 years of age

- Chronic medical conditions - chronic lung disease (including moderate to severe asthma), serious heart conditions, hypertension, diabetes, renal failure, liver disease, and cancer are more common in people living with HIV

- Chronic smokers

- Low-functioning immune system - occurs when someone has a low CD4 T-cell count, is not receiving antiretroviral treatment, or is not taking HIV medications daily

If you are Higher Risk for Illness from COVID-19

If you have one or more of the above risk factors, follow the steps below:

-Work to become virally suppressed if you are not already, including seeking medical care if you are not currently engaged with an HIV care provider. Call a provider to determine the best plan for you to move forward

-Contact your healthcare provider to ask about obtaining extra medications to have on hand in case there is a COVID-19 outbreak in your community requiring you to stay home for a prolonged period of time

-Talk to your pharmacist and/or healthcare provider about changing to mail order delivery of medications when possible

-Ensure you have over-the-counter medicines and medical supplies (tissues, etc.) to treat fever and other symptoms if you contract COVID-19.

-Ensure you have enough household items and groceries on hand so you are prepared to stay home for a prolonged period of time

-Avoid crowds as much as possible

-Avoid cruise travel and non-essential air travel

 Suggestions from Local HIV Doctors & Nurses in Midwest*

-Take social distancing seriously

-Cancel non-essential appointments at clinics. If your HIV numbers are stable and you take your medications daily, reschedule your appointments until a later date. Don't take the chance of exposure by going to the clinic; clinics have defined routine HIV follow up and PrEP visits as nonessential and these should be delayed for a few months. Also consider delaying preventive care, such as mammograms and colonoscopies

-Many healthcare facilities are instituting telehealthcare. If you have a medical issue, check to see if telehealth is available. Cold-type symptoms should be assessed through telehealth if possible. If you are having trouble breathing, you should go to the emergency department 

-Many providers are OK'ing prescriptions for stable patients without making them come into the clinic for the next few months. You can also communicate the way you usually do with your healthcare providers regarding refills

-Work from home, if possible, for at least a few weeks. If your employer requires a note, ask your provider. If you are not able to work from home, practice social distancing at work (stay at least 6 feet apart) and avoid people with a cough

-If you are living with HIV but not on medication, reach out and call a provider to determine the best plan for you to move forward. If you are living with HIV that is not controlled or are newly on medication without a documented suppressed viral load, call your provider and keep your lab testing follow-up appointments

-Testing for COVID-19 is not readily available, and there is not a lot of information about what the risk for people living with HIV is, so evidence-based recommendations are not available. Look to the CDC for guidance as this situation is constantly evolving and there have been, and there will continue to be, numerous updates. There is a great deal we do not know yet, so taking the same precautions as are being recommended for the general public is a good idea

-Maintain a healthy lifestyle; staying healthy will help your immune system fight off infection should it occur. Reduce smoking/vaping, monitor your blood sugar if you are diabetic, take medications for high blood pressure as prescribed, etc.

*These recommendations are not intended to replace professional medical advice, but rather to be a helpful resource for you during this challenging time

If you are Feeling Sick 

If you think you have been exposed to COVID-19 and develop a fever and symptoms such as a cough or shortness of breath:

1. Stay home and follow CDC advice

2. Call your healthcare provider for medical advice. Let them know your symptoms and tell them you may have COVID-19. This will help them take care of you and keep other people from getting infected or exposed

3. Avoid public transportation, ride-sharing, or taxis if possible

If you are not sick enough to be hospitalized, you can recover at home; discuss with you medical team and follow their recommendations. Get medical attention immediately if you have any of the emergency warning signs listed below:

-Trouble breathing

-Persistent pain or pressure in the chest

-New confusion or inability to arouse (wake up)

-Bluish lips or face

Planning for if You Get Sick

-Maintain a social network; stay in touch with others by telephone, email, or other remote technology. You may need to ask for help from friends, family, neighbors, community health workers, etc. if you get sick; and maintaining a social network will also keep spirits up while isolated or quarantined

-Determine who can care for you if your caregiver gets sick

-Establish plan for clinical care if isolated/quarantined, including telemedicine options and online health portals such as "MyChart"Ensure ample medication supply: 30-day supply, and ideally a 90 day supply, at all times for each medication you take

If you are Feeling Well 

Follow these recommended precautionary measures to prevent COVID-19 Infection:

-Keep up to date and heed the advice of Iowan health officials and the CDC; the best way to prevent illness is to avoid being exposed to the virus

-Continue to take all medications (including your HIV medications) as prescribed, unless directed otherwise by your doctor. Currently there are NOT shortages of HIV medications

-Avoid large gatherings and gatherings in small public places; wear a cloth face mask in public places where it can be hard to maintain a distance of at least 6 feet from other people

-Eat right, try to get at least 8 hours of sleep, and reduce stress as much as possible to keep your immune system healthy

Important Resources for People Living with HIV 

• COVID-19: What People With HIV Should Know (CDC): This page answers a lot of questions about HIV and COVID-19
• Iowa HIV, STD, & HCV Services Directory: This directory includes information on testing locations, client services, and Ryan White Clinical Services. Testing services may be reduced at this time, contact your local testing services for availability.
• Ryan White Care and Support Services: This website explains the benefits and services offered through the Ryan White Program, which is available for all Persons Living with HIV in the United States and can help you receive case management, housing, transportation, mental health services, and more. Iowa residents can apply for Ryan White Part B Services with the assistance of case managers
• PrEP Iowa: PrEP Iowa provides information on PrEP in Iowa including finding a provider, telePrEP, getting help with payment and other resources
• Naloxone Iowa: Naxolone Iowa help Iowans who want or need to have naloxone on hand get the tools they need. This program allows for individuals to receive tele-naloxone.
• MyIACondoms: This website helps Iowan's find free condoms near them with their condom locator tool. Please note, due to the COVID-19 situation some sites that supply condoms may be closed or operating under different hours. Please call the site directly if you plan to go there to get condoms.
• Coronavirus Disease 2019 (COVID-19): Reducing Stigma (CDC): People with HIV have lived experience in dealing with stigma and can be allies in reducing COVID-19 stigma, this page addresses how to reduce stigma and help prevent the spread of rumors about COVID-19

Note: Be wary of misinformation, myths, and false recommendations surrounding COVID-19. Always check the CDC website for accurate guidance. This is a rapidly evolving situation and we recommend continuing to check reputable sources like the State of Iowa's COVID-19 Information Page, Iowa Department of Public Health, and the CDC for the most up to date and accurate information. 

Sources:

https://www.poz.com/article/people-hiv-need-know-new-coronavirus

https://www.thebody.com/health/hiv-coronavirus-covid-19

https://www.thebodypro.com/article/covid-19-cdc-recommendations-hiv-clinicians

https://www.cdc.gov/coronavirus/2019-ncov/if-you-are-sick/caring-for-yourself-at-home.html

https://www.cdc.gov/coronavirus/2019-ncov/if-you-are-sick/steps-when-sick.html

https://www.cdc.gov/coronavirus/2019-ncov/symptoms-testing/symptoms.html

https://www.cdc.gov/coronavirus/2019-ncov/specific-groups/high-risk-complications.html

https://aidsinfo.nih.gov/guidelines/html/8/covid-19-and-persons-with-hiv--interim-guidance-/0? utm_source=AIDSinfo&utm_medium=email&utm_campaign=3-20-20-COVID19_Guidance