Abstract
The present commentary explored the intersecting nature of the COVID-19 and HIV pandemics to identify a shared research agenda using a syndemic approach. The research agenda posits the following questions. Questions around HIV infection, transmission, and diagnosis include: (i) molecular, genetic, clinical, and environmental assessments of COVID-19 in people living with HIV, (ii) alternative options for facility-based HIV testing services such as self- and home-based HIV testing, and (iii) COVID-19 related sexual violence and mental health on HIV transmission and early diagnosis. These and related questions could be assessed using Biopsychosocial and socio-ecological models. Questions around HIV treatment include: (i) the effect of COVID-19 on HIV treatment services, (ii) alternative options for facility-based treatment provision such as community-based antiretroviral therapy groups, and (iii) equitable distribution of treatment and vaccines for COVID-19, if successful. Bickman's logic model and the social determinants of health framework could guide these issues. The impact of stigma, the role of leveraging lessons on sustained intra-behavioral change, the role of medical mistrust and conspiracy beliefs, and the role of digital health on integrated management of HIV care and spectrum of care of COVID-19 need assessment using several frameworks including Goffman's stigma framework, Luhmann's Trust theory, and Gidden's theory of structuration. In conclusion, the potential research agenda of this commentary encompasses a variety of research fields and disciplinary areas—clinicians, laboratory scientists, public health practitioners, health economists, and psychologists—, and suggests several theoretical frameworks to guide examination of complex issues comprehensively.
Highlights
The human immunodeficiency virus (HIV) [1] and novel coronavirus disease 2019 (COVID-19) [2] pandemics have some similarities
HIV transmission is high in refugee camps and among people who consume excessive alcohol [4, 5], and AIDS-related mortality is high among older populations and people with one or more comorbidities
While the aim of this article is to ask a myriad of questions and suggest several frameworks, synthesizing lessons learned from the successes and failures of the HIV pandemic journey is vital
Summary
The human immunodeficiency virus (HIV) [1] and novel coronavirus disease 2019 (COVID-19) [2] pandemics have some similarities. HIV is primarily transmitted through unsafe sex, blood contact, and mother-to-child transmission, whereas COVID-19 is transmitted through droplets and direct contact. Both conditions may initially present with influenza-like symptoms, such as fever, cough, and difficulty in breathing, the severity and clinical stage varies [3]. Some population groups, including people who are older (and male), consume alcohol, have one or more comorbid condition, and live in densely populated settings such as in refugee camps, are at a higher risk of severe COVID-19 related infection or death. Isolation of confirmed cases, quarantine, contact tracing, social distancing, hand washing, and use of alcohol-based sanitizer and personal protective equipment (PPE) are techniques implemented to reduce the risk of COVID-19 transmission
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