Statement from the ASHM COVID-19 Taskforce regarding the Prioritisation of COVID-19 Vaccines for People Living with HIV

Prepared by members of the ASHM COVID-19 Taskforce​

UPDATED ON: 14 April 2021.

Download PDF

ATAGI has recommended that:

  • the COVID-19 Pfizer vaccine be preferred over AstraZeneca for adults aged under 50 years. This is because there is a potentially higher risk of thrombosis with thrombocytopenia in people aged under 50, who receive the AstraZeneca vaccine
  • the AstraZeneca vaccine be used in adults aged under 50, if the benefits outweigh the risks for that person – and they have made an informed decision based on the risks and benefits
  • people who have had the first dose of AstraZeneca without any serious adverse effects, can be given the second dose. This includes people aged under 50.

Healthcare providers may wish to continue having detailed discussions with patients about the risks and benefits of the AstraZeneca vaccine in line with ATAGI advice, regardless of the age of the patient, ensuring fully informed consent before vaccination.

Updated safety advisory – rare and unusual blood clotting syndrome (thrombosis with thrombocytopaenia):

A number of studies to date have shown that people living with HIV (PLWHIV) appear to be at increased risk of infection with SARS-CoV-2 and at increased risk for poorer outcomes following infection with SARS-CoV-2. 

The ASHM COVID-19 Taskforce recommends the following with respect to the provision of COVID-19 vaccines to PLWHIV in Australia:

That all PLWHIV in Australia who meet the Phase 1a criteria of Australia’s COVID-19 vaccine roll-out strategy should be offered a vaccine during Phase 1a of the roll-out and that all remaining PLWHIV should be offered a COVID-19 vaccine during Phase 1b of the roll-out. 

The Commonwealth, States and Territories should consult closely with HIV peak organisations, clinicians and researchers who specialise in HIV to optimise the engagement of PLWHIV during the roll-out of COVID-19 vaccines.

That all PLWHIV should be offered a vaccine irrespective of whether or not they have a Medicare number, including people who are incarcerated, people in migrant detention centres, people living in Australia on temporary visas and people who are in Australia with an undocumented status.  

All efforts should be made to address any obstacles that may arise during the roll-out of vaccines to PLWHIV as a result of geographic, social, ethnic and cultural factors. For example, vaccine provision to Indigenous Australians who live in remote regions, to populations who are culturally and linguistically diverse, to people who are homeless, or have housing insecurity and to people who have a substance use disorder. 

That Australia’s COVID-19 vaccine roll-out strategy should be designed to provide high levels of personal and medical confidentiality for PLWHIV when they are engaging with healthcare providers e.g. when they are seeking a COVID-19 vaccine, when they are referred for a COVID-19 vaccine from one healthcare provider to another and at the time that they receive a COVID-19 vaccine.  

COVID-19 vaccination services must not provide opportunities for linkage to Federal, State, or Territory criminal justice services that would lead to arrests and/or charges for outstanding warrants, commercial sex work, substance-use, visa expiry, undocumented status, or other charges. 

The ASHM COVID-19 Taskforce’s interpretation of the currently available published and pre-print literature is that PLWHIV do have an increased risk of infection with SARS-CoV-2, and an increased risk of poorer outcomes following infection with SARS-CoV-2 (see review of literature below).

Upon review of the literature it is highly likely that there are several factors that may explain the increased risk of infection and poorer outcomes with SARS-CoV-2 in PLWHIV including [1] the effect of HIV upon the immune system, including in virologically suppressed populations, [2] the potential interplay between the impact of SARS-CoV-2 infection and HIV upon the immune system, [3] the presence of comorbidities, [4] age and [5] other factors including ethnicity and socioeconomic status which may prevent PLWHIV from being able to safely protect themselves from exposure to SARS-CoV-2 infection. A detailed discussion of these factors is beyond the scope of this position statement.

Recommendation 1 is in keeping with recommendations from the Australian Technical Advisory Group on Immunisation (ATAGI), the Australian Government’s COVID-19 vaccination policy and the Australian Government’s COVID-19 vaccine roll-out strategy [1-5]. 

The rationale for Recommendations 2 and 3 are based upon the principles of social justice and the need to have the highest possible uptake of COVID-19 vaccines by PLWHIV. No person living with HIV in Australia should be denied a COVID-19 vaccination based upon their life circumstances be it, for example, that they do not have a Medicare number, do not live in metropolitan areas, or are incarcerated.  The knowledge that strict patient confidentiality will be maintained and that no arrests, prosecutions or placement in migrant detention centres will occur when people present for a COVID-19 vaccine will help to maximise the uptake of COVID-19 vaccines by all PLWHIV in Australia.

Recommendations 2 and 3 are in keeping with the ‘human right to science’ as per the United Nations Committee on Economic, Social Rights, Comment 25 [6].

The ASHM COVID-19 Taskforce undertook a review of available published and pre-print literature from December 2019 until January 2021 to address COVID-19 outcomes in people living with HIV (PLWHIV). This review is not a systematic review or meta-analysis of the literature, nor is it exhaustive and the Taskforce wishes to emphasis that scientific and clinical research findings regarding COVID-19 and its impact on PLWHIV will continue to grow and change. 

Increased risk of infection
A systematic review and meta-analysis of over 144,000 people hospitalised with COVID-19 infection in North America, Europe, and Asia between January and June 2020 found that the pooled prevalence of HIV infection in these patients was twice as high as the pooled prevalence of HIV infection in the countries’ general populations, (1.22% (95% confidence interval (CI): 0.61%- 2.43%) versus 0.65% (95% CI: 0.48%-0.89%), respectively [7]. Another review in settings in North and South America, Europe, the United Kingdom (UK) and Asia examined the relative risk of PLWHIV being diagnosed with HIV across 23 studies. The review found that in 11/23 studies, the relative risk of PLWHIV being diagnosed with COVID-19 was significantly greater than the expected rate based upon background rates of HIV infection in those settings [8]. Similarly, when the rates of COVID-19 diagnoses were compared across all 23 studies, the observed versus expected rate was higher in PLWHIV (Wilcoxon signed-rank test, p < 0.01) [8]. Other studies not included in these two abovementioned reviews, also have reported similar findings [9,10,11]. 

No increased risk of infection
Two retrospective reviews did not find an increased risk of COVID-19 in PLWHIV [12,13] although relatively small numbers of PLWHIV with COVID-19 were included in these studies. 

Increased risk of hospitalisation

An analysis was undertaken of people diagnosed with COVID-19 in the United States across a well-established multicentre research network, TriNETX, which has access to records of over 50 million patients who are cared for predominantly in large urban centres [14]. The authors compared 404 PLWHIV diagnosed with COVID-19 to a propensity-matched cohort of 49,763 non-PLWHIV with COVID-19 to offset factors that may confound the study findings. They reported that in unmatched analyses, PLWHIV had a higher risk of hospitalisation (risk ratio (RR) 1.83, 95% CI: 1.5-2.24). The authors then performed propensity matching 1:1 for body mass index, diabetes, hypertension, chronic lung disease, chronic kidney disease, race, history of nicotine dependence and sex. The risk of hospitalisation remained higher for PLWHIV (RR 1.70, 95% CI: 1.21-2.38) [14]. 

Another study in New York State used matched HIV surveillance data, hospitalisation databases and laboratory-confirmed COVID-19 diagnoses [10]. In this study, Tesoriero et al also found that PLWHIV versus non-PLWHIV had a significantly increased risk of hospitalisation following adjustment for age, sex and region (standardized rate ratio (sRR) 1.38 95% CI: 1.29-1.47) [10]. Of note in this study, hospitalisation rates were higher in those not virologically suppressed and with lower CD4+ T cell counts [10]. 

Johnston calculated the relative risk of hospitalisation of PLWHIV versus non-PLWHIV within the general population in nine studies.  The study reported that in 7/9 studies, PLWHIV had an elevated risk of hospitalisation and this reached significance in five of the seven studies (lower bound of the 95% CI >1) [8]. However, when compared for all nine studies, there was no difference in hospitalisation rates for PLWHIV [8].

No increased risk of hospitalisation
Other studies compared hospitalisation rates for PLWHIV versus non-PLWHIV in in New York City’s public hospitals [15] and in the US state of Georgia [16] and found no increased risk of hospitalisation for PLWHIV.  Again, a relatively small number of PLWHIV with COVID-19 were included in these studies. 

Increased risk of mortality

In a large retrospective cohort study of adults from the United Kingdom, Bhaskaran and colleagues linked an electronic primary care dataset to national death registrations [17]. 17, 202, 905 people were evaluated of whom 27,480 were PLWHIV. The authors compared the risk of mortality for adults diagnosed with COVID-19 depending on whether they were PLWHIV or non-PLWHIV.  COVID-19 deaths occurred in 25 PLWHIV and in 14,857 non-PLWHIV. The authors found that PLWHIV with COVID-19 had a higher risk of mortality after adjusting for age and sex (hazard ratio (HR) 2.09 (95% CI:1.96-4.30; p< 0.0001). Following further adjustment for comorbidities, smoking, ethnicity and deprivation, the risk of mortality remained significantly higher for PLWHIV (HR 2.59 (95% CI: 1.74-3.85; p <0.001) [17]. Of note, the study did not include data on CD4+ cell counts, HIV viral loads, or prior AIDS illnesses. 

A population cohort study undertaken in South Africa was designed to evaluate risk factors for COVID-19 death in the general population. The study analysed linked data from approximately 3.5 million patients living in the Western Cape Province who attended public health sector facilities, and of whom 16% were HIV seropositive [18]. Data were available on CD4+ cell counts, HIV viral loads and antiretroviral use for PLWHIV.  Of 3,460 932 people, 22,308 people were diagnosed with COVID-19. 625 COVID-19 deaths occurred in public sector patients, of whom 115 were PLWHIV. Notably HIV virological suppression was prevalent in PLWHIV. The study found that in all public sector patients, HIV was associated with an increased hazard for mortality after adjusting for age, sex and comorbidities (adjusted (a) HR 2.14 (95% CI: 1.70-2.70). This finding was irrespective of whether PLWHIV were viraemic or immunosuppressed.  In hospitalised patients, HIV remained significantly associated with an increased risk for death (aHR 1.45 (95% CI: 1,14-1.84)) [18]. Finally, the authors estimated the standardized mortality rate (SMR) of PLWHIV (e.g. the number of deaths in PLWHIV you would expect to see if they had the same risk as non-PLWHIV of the same age and sex). The SMR of PLWHIV vs non-PLWHIV was significantly higher at 2.39 (95% CI 1.96-2.86) [18].

Other studies from international jurisdictions have reported increased COVID-19 mortality in PLWHIV compared to non-PLWHIV populations. Geretti et al prospectively examined outcomes of patients hospitalised with COVID-19 across 207 centres in the UK [19]. 47,592 patients were evaluated and 122 (0.26%) were HIV positive. The authors reported that the overall 28- day mortality was not different between PLWHIV and non-PLWHIV.  However, in people under 60 years of age, PLWHIV had increased mortality compared to non-PLWHIV (21.3% versus 9.6%, p < 0.01). In further analyses, after adjusting for sex, ethnicity, age, 10 comorbidities and baseline hypoxia, PLWHIV had a higher mortality rate (aHR 1.63 (95% CI: 95% CI 1.07-2.4; p=0.02)), which was even higher in people less than 60 years of age.  The study did not include data on CD4+ cell counts, HIV viral loads, or prior AIDS illnesses [19]. 

Tesoriero et al’s population study from New York State, described above, also found a higher mortality rate in younger hospitalised HIV positive people [10]. Overall, hospitalised PLWHIV with COVID-19 died a rate 2.55 fold higher than that of non-PLWHIV (95% CI: 2.22-2.93), thought to be a result of much higher hospitalisation rates for PLWHIV. In those PLWHIV under 40 years of age the unadjusted mortality rate was high at 5.74 (95% CI: 2.14-15.42) [10].   Similarly, Vizcarra and colleagues who undertook a single centre prospective cohort study of hospitalised PLWHIV in Madrid found that mortality in PLWHIV aged 50-59 years was double that of the general Spanish population (8% vs 4%) [20].

Ranges of mortality in PLWHIV were evaluated in a systematic review and meta-analysis that evaluated seven studies spanning populations in Europe and New York City [7]. The combined mortality rate was 14.09 % (95%CI 5.78-30.50) with the highest combined country mortality rate being 35.4% in the United States [7].

Several other retrospective studies, using different designs and statistical analyses, have shown that HIV positive serostatus is associated with, or affords higher rates of mortality [21-27]. 

No increased risk of mortality

No difference in mortality between PLWHIV and non-PLWHIV has been reported in several studies. One systematic review and meta-analysis [28] evaluated seven studies, three of which are discussed above [18,19,14]. The study evaluated 172,451 HIV seronegative people and 4,735 HIV seropositive people with COVID-19.  No increased risk of mortality was observed in PLWHIV (risk ratio 0.99 (95% CI: 0.82-1.19)) [28].  Similarly, Johnston calculated the relative risk of mortality in PLWHIV across 13 studies, which reported deaths of 192 PLWHIV with COVID-19 [8].  The review found that in 10/13 studies mortality was lower than that of the general population, but this reached significance in only one study [8]. Cooper et al undertook a systematic review of eight studies that evaluated only 70 PLWHIV with COVID-19 and found that PLWHIV did not have poorer outcomes overall, however mortality was not independently assessed as an outcome [29].

In a population-based cohort study in Wuhan the standardised case-fatality rates in PWLHIV (3.68) were similar to that of the general population of Wuhan (7.74) [30]. The abovementioned TriNETX research network reported on mortality in their propensity matched cohort. They found that in univariate analysis, PLWHIV had a higher 30-day mortality rate (RR 1.55, 95% CI 1.01-2.39). However, after 1:1 propensity score matching, no difference in mortality was observed between PLWHIV and non-PLWHV (RR 1.33, 95% CI 0.68-2.57) [14].

Several retrospective reviews including case-matched studies of populations in Europe, the United States and South Africa, have not found an increase in mortality in PLWHIV [31-39,11,40]. Of note, many of these studies have small sample sizes. 

There are several other studies reporting on COVID-19 in PLWHIV that have not reported on outcomes of PLWHIV versus non-PLWHIV and are listed here for completeness’s sake [41-47]. Many of these studies are small, descriptive case studies. 

1.    Australian Government, Department of Health, Australian COVID-19 Vaccination Policy [Updated 11 December 2020 cited 17.02.2021]. Available from: Accessed 17.02.2021.

2.    Australian Technical Advisory Group on Immunisation (ATAGI) - Preliminary advice on general grinciples to guide the prioritisation of target populations in a COVID-19 vaccination program in Australia. [Published 13 November 2020 cited 17.02.2021]. Available from: Accessed 17.02.2021.

3.    Australian Government, Department of Health, Australia’s COVID-19 vaccine national roll-out strategy. [cited 17.02.2021]. Available from: Accessed 17.02.2021.

4.    Australian Government, Department of Health. Australia's COVID-19 Vaccine and Treatment Strategy. [Published 18 August 2020 cited 17.02.2021]. Available from: Accessed 17.02.2021.

5.    Australian Government, Department of Health. Advice for people at risk of coronavirus (COVID19). [Updated 1 February 2021 cited 17.02.2021]. [Internet] Available from: Accessed 17.02.2021.

6.    United Nations Committee on Economic, Social and Cultural Rights. General comment No. 25 (2020) on Science and economic, social and cultural rights. Art. 15.1.b, 15.2, 15.3 and 15.4 [cited 2020 Apr 15]. Available from: Accessed 17.02.2021.

7.    Ssentongo P, Heilbrunn ES, Ssentongo AE, et al. Prevalence of HIV in patients hospitalized for COVID-19 and associated outcomes: a systematic review and meta-analysis. medRxiv. 2020;2020.07.03.20143628. Accessed 02.02.2021.

8.    Johnston R. The first 6 months of HIV-SARS-CoV-2 coinfection: outcomes for 6947 individuals. Curr Opin HIV AIDS. 2021 Jan;16(1):54-62. doi: 0.1097/COH.0000000000000654. PMID: 33165007. Accessed 02.02.2021. 

9.    Sachdev D, Mara E, Ling Hsu, et al. COVID-19 Susceptibility and Outcomes Among People Living With HIV in San Francisco 2021 Jan 1; 86(1): 19–21. Published online 2020 Nov 20. doi: 10.1097/QAI.0000000000002531 PMCID:  PMC7727319. Accessed 02.0.2021. 

10.    Tesoriero JM, Swain CE, Pierce JL, et al. COVID-19 Outcomes Among Persons Living With or Without Diagnosed HIV Infection in New York State. JAMA Netw Open. 2021 Feb 1;4(2):e2037069. doi: 10.1001/jamanetworkopen.2020.37069. Accessed 16.02.2021.

11.    Parker A, Koegelenberg CFN, Moolla MS, et al. High HIV prevalence in an early cohort of hospital admissions with COVID-19 in Cape Town, South Africa. S Afr Med J. 2020 Aug 21;110(10):982-987. doi: 10.7196/SAMJ.2020.v110i10.15067. PMID: 33205724. Accessed 03.02.2021. 

12.    Marcello RK, Dolle J, Grami S, et al. Characteristics and outcomes of COVID-19 patients in New York City's public hospital system. PLoS One. 2020;15(12):e0243027. Published 2020 Dec 17. doi:10.1371/journal.pone.0243027. Accessed 02.02.2021. 

13.    Charre C, Icard V, Pradat P, et al. Coronavirus disease 2019 attack rate in HIV-infected patients and in preexposure prophylaxis users. AIDS. 2020;34(12):1765-1770. doi:10.1097/QAD.0000000000002639. Accessed 02.02.2021. 

14.    Hadi YB, Naqvi SFZ, Kupec JT, Sarwari AR.Characteristics and outcomes of COVID-19 in patients with HIV: a multicentre research network study. AIDS. 2020 Nov 1;34(13):F3-F8. doi: 10.1097/QAD.0000000000002666. PMID: 32796217. Accessed 02.02.2021. 

15.    Marcello RK,  Dolle J,  Grami S et al, Characteristics and Outcomes of COVID-19 Patients in New York City’s Public Hospital System doi: Accessed 02.02.2021.

16.    Killerby ME, Link-Gelles R, Haight SC, et al. Characteristics Associated with Hospitalization Among Patients with COVID-19 — Metropolitan Atlanta, Georgia, March–April 2020. MMWR Morb Mortal Wkly Rep 2020;69:790–794. DOI: icon. 
Accessed 02.02.2021. 

17.    Bhaskaran K, Rentsch CT, MacKenna B, et al, COVID-19 death: a population-based cohort analysis of UK primary care data and linked national death registrations within the OpenSAFELY platform. Lancet HIV. 2021 Jan;8(1):e24-e32. doi: 10.1016/S2352-3018(20)30305-2. Epub 2020 Dec 11. PMID: 33316211; PMCID: PMC7773630. Accessed 02.02.2021. 

18.    Boulle A, Davies MA, Hussey H, et al. Risk factors for COVID-19 death in a population cohort study from the Western Cape Province, South Africa. Clin Infect Dis. 2020 Aug 29:ciaa1198. doi: 10.1093/cid/ciaa1198. Epub ahead of print. PMID: 32860699; PMCID: PMC7499501. Accessed 02.02.2021. 

19.    Geretti AM, Stockdale AJ, Kelly SH et al. Outcomes of COVID-19 related hospitalization among people with HIV in the ISARIC WHO Clinical Characterization Protocol (UK): a prospective observational study. Clin Infect Dis. 2020 Oct 23:ciaa1605. doi: 10.1093/cid/ciaa1605. Epub ahead of print. PMID: 33095853; PMCID: PMC7665382. Accessed 02.02.2021. 

20.    Vizcarra P, Pérez-Elías MJ, Quereda C, et al, Description of COVID-19 in HIV-infected individuals: a single-centre, prospective cohort The Lancet  VOLUME 7, ISSUE 8, E554-E564, AUGUST 01, 2020 Accessed 02.02.2021.

21.    Argenziano MG, Bruce SL, Slater CL et al. Characterization and clinical course of 1000 patients with coronavirus disease 2019 in New York: retrospective case series. BMJ 2020; 369 doi: (Published 29 May 2020).Cite this as: BMJ 2020;369:m1996. Accessed 03.02.2021. 

22.    Dandachi D, Geiger G, Montgomery MW et al. Characteristics, Comorbidities, and Outcomes in a  multicenter Registry of Patients with HIV and Coronavirus Disease-19. Clin Infect Dis. 2020 Sep 9:ciaa1339. doi: 10.1093/cid/ciaa1339. Epub ahead of print. PMID: 32905581; PMCID: PMC7499544. Accessed 02.02.2021. 

23.    Ho HE, Peluso MJ, Margus C, et al. Clinical outcomes and immunologic characteristics of Covid-19 in people with HIV [published online ahead of print, 2020 Jun 30]. J Infect Dis. 2020;jiaa380.doi:10.1093/infdis/jiaa380. Accessed 02.02.2021. 

24.    Suwanwongse K, Shabarek N. Variation in mortality of HIV/SARS‐CoV-2 coinfected patients in the Bronx, New York City Journal of Medical Virology Volume 93, Issue 2 29 July 2020 Accessed 02.0.021. 

25.    Childs K, Post FA, Norcross C et al Hospitalized Patients With COVID-19 and Human Immunodeficiency Virus: A Case Series. Clin Infect Dis. 2020 Nov 5;71(8):2021-2022. doi: 10.1093/cid/ciaa657. PMID: 32459833; PMCID: PMC7314116. Accessed 02.02.2021. 

26.    Guo, W, Ming F and Dong Y et al  A Survey for COVID-19 Among HIV/AIDS Patients in Two Districts of Wuhan, China (3/4/2020). Available at SSRN: or Accessed 02.02.2021. 

27.    Mehta SA, Rana MM, Motter JD, et al; Incidence and Outcomes of COVID-19 in Kidney and Liver Transplant Recipients With HIV: Report From the National HOPE in Action Consortium. Transplantation. 2021 Jan 1;105(1):216-224. doi: 10.1097/TP.0000000000003527. PMID: 33165238. Accessed 03.02.2021. 

28.    Sarkar S, Khanna P, Singh AK. Impact of COVID-19 in patients with concurrent co-infections: A systematic review and meta-analysis. J Med Virol. 2020 Dec 17. Accessed 17.02.2021. 

29.    Cooper TJ, Woodward BL, Harky A Coronavirus disease 2019 (COVID‐19) outcomes in HIV/AIDS patients: a systematic review First published: 15 July 2020 Accessed 02.02.2021. 

30.    Huang J, Xie N, Hu X, et al; Epidemiological, virological and serological features of COVID-19 cases in people living with HIV in Wuhan City: A population-based cohort study. Clin Infect Dis. 2020 Aug 17:ciaa1186. doi: 10.1093/cid/ciaa1186. Epub ahead of print. PMID: 32803216; PMCID: PMC7454403. Accessed 03.02.2021, 

31.    Sigel K, Swartz T, Golden E, et al; Coronavirus 2019 and People Living With Human Immunodeficiency Virus: Outcomes for Hospitalized Patients in New York City. Clin Infect Dis. 2020 Dec 31;71(11):2933-2938. doi: 10.1093/cid/ciaa880. PMID: 32594164; PMCID: PMC7337691. Accessed 03.02.2021. 

32.    Shalev N, Scherer M, LaSota ED, et al; Clinical Characteristics and Outcomes in People Living With Human Immunodeficiency Virus Hospitalized for Coronavirus Disease 2019. Clin Infect Dis. 2020 Nov 19;71(16):2294-2297. doi: 10.1093/cid/ciaa635. PMID: 32472138; PMCID: PMC7314170. Accessed 03.02.2021. 

33.    Härter G, Spinner CD, Roider J, et al; COVID-19 in people living with human immunodeficiency virus: a case series of 33 patients. Infection. 2020 Oct;48(5):681-686. doi: 10.1007/s15010-020-01438-z. Epub 2020 May 11. PMID: 32394344; PMCID: PMC7211976. Accessed 03.02.2021. 

34.    Karmen-Tuohy S, Carlucci PM, Zervou FN, et al; Outcomes Among HIV-Positive Patients Hospitalized With COVID-19. J Acquir Immune Defic Syndr. 2020 Sep 1;85(1):6-10. doi: 10.1097/QAI.0000000000002423. PMID: 32568770; PMCID: PMC7446982. Accessed 03.02.2021. 

35.    Isernia V, Julia Z, Le Gac S, SARS-COV2 infection in 30 HIV-infected patients followed-up in a French University Hospital. Int J Infect Dis. 2020 Dec;101:49-51. doi: 10.1016/j.ijid.2020.09.1436. Epub 2020 Sep 26. PMID: 32987182; PMCID: PMC7518976. Accessed 03.02.2021.

36.    Gervasoni C, Meraviglia P, Riva A, et al Clinical Features and Outcomes of Patients With Human Immunodeficiency Virus With COVID-19. Clin Infect Dis. 2020 Nov 19;71(16):2276-2278. doi: 10.1093/cid/ciaa579. PMID: 32407467; PMCID: PMC7239244. Accessed 03.02.2021. 

37.    Nagarakanti SR, Okoh AK, Grinberg S, et al Clinical outcomes of patients with COVID-19 and HIV coinfection. J Med Virol. 2020 Sep 19:10.1002/jmv.26533. doi: 10.1002/jmv.26533. Epub ahead of print. PMID: 32949148; PMCID: PMC7537324. Accessed 03.02.2021. 

38.    Chilimuri S, Sun H, Alemam A, et al; Predictors of Mortality in Adults Admitted with COVID-19: Retrospective Cohort Study from New York City. West J Emerg Med. 2020 Jul 8;21(4):779-784. doi: 10.5811/westjem.2020.6.47919. PMID: 32726241; PMCID: PMC7390589. Accessed 03.02.2021. 

39.    Stoeckle K, Johnston CD, Jannat-Khah DP,et al; COVID-19 in Hospitalized Adults With HIV. Open Forum Infect Dis. 2020 Aug 1;7(8):ofaa327. doi: 10.1093/ofid/ofaa327. PMID: 32864388; PMCID: PMC7445584. Accessed 03.02.2021.

40.    SachdevD, Mara E, Hsu L, et al. COVID-19 Susceptibility and Outcomes Among People Living With HIV in San Francisco. J Acquir Immune Defic Syndr. 2021;86(1):19-21. doi:10.1097/QAI.0000000000002531. Accessed 03.02.2021. 

41.    Meyerowitz EA, Kim AY, Ard KL, et al; Disproportionate burden of coronavirus disease 2019 among racial minorities and those in congregate settings among a large cohort of people with HIV. AIDS. 2020 Oct 1;34(12):1781-1787. doi: 10.1097/QAD.0000000000002607. PMID: 32604138; PMCID: PMC7499878. Accessed 03.02.2021. 

42.    Collins LF, Moran CA, Oliver NT et al; Clinical characteristics, comorbidities and outcomes among persons with HIV hospitalized with coronavirus disease 2019 in Atlanta, Georgia. AIDS. 2020 Oct 1;34(12):1789-1794. doi: 10.1097/QAD.0000000000002632. PMID: 32675581; PMCID: PMC7484356. Accessed 03.02.2021. 

43.    Byrd KM, Beckwith CG, Garland JM et al; SARS‐CoV‐2 and HIV coinfection: clinical experience from Rhode Island, United States. 
Journal of the International AIDS Society Volume 23, Issue 7 ee255732020 June 19 Accessed 03.02.2021.

44.    Cyrus E, Clarke R, Hadley D, et al; The impact of COVID-19 on African American communities in the United States. medRxiv [Preprint]. 2020 May 19:2020.05.15.20096552. doi: 10.1101/2020.05.15.20096552. Update in: Health Equity. 2020 Oct 30;4(1):476-483. PMID: 32511486; PMCID: PMC7273254. Accessed 03.02.2021. 

45.    Sze S, Pan D, Nevill CR,et al; Ethnicity and clinical outcomes in COVID-19: A systematic review and meta-analysis. EClinicalMedicine. 2020 Dec;29:100630. doi: 10.1016/j.eclinm.2020.100630. Epub 2020 Nov 12. PMID: 33200120; PMCID: PMC7658622. Accessed 03.02.2021. 

46.    Maggiolo F, Zoboli F, Arosio M, et al SARS‐CoV‐2 infection in persons living with HIV: A single center prospective cohort Journal of Medical VirologyVolume 93, Issue 2 First published: 24 July 2020 Accessed 03.02.2021. Accessed 03.02.2021. 

47.    Di Biagio, A; Ricci, E; Calza, L; et al; Factors associated with hospital admission for COVID-19 in HIV patients. AIDS. 2020 Nov 1;34(13):1983-1985. doi: 10.1097/QAD.0000000000002663. PMID: 32796214. Accessed 03.02.2021. 

* This document was written by the ASHM COVID-19 Taskforce Chair and was reviewed by the ASHM Taskforce Co-Chair, members of the Virology, HIV, Research & Understanding the Data Cluster Taskforce Group Members and the ASHM CEO.

ASHM COVID-19 Taskforce Chair: A/Prof Edwina Wright
ASHM COVID-19 Taskforce Co-Chair: Mr Scott McGill
Members of the Virology, HIV and Research & Understanding the Data Clusters


Martyn French 
Sharon Lewin 
Thomas Rasmussen 


Adam Ehm 
Alison Cowell 
Belinda Wozencroft 
Brian Price 
Charles Gilks 
Darren Russell 
Darryl O’Donnell 
Dean Murphy 
Edwina Wright 
Jenny Hoy  
Joan Ingram (NZ) 
John Rule 
Kathy Petoumenous 
Lauren Foy 
Mark Bloch 
Megan McAnally 
Nick Medland 
Olga Vujovic 
Tiffany Tran 

Research and Understanding the Data

Carla Treloar 
Charles Gilks 
Gail Matthews 
Graham Brown 
Jack Wallace 
James McMahon 
John Rule 
Julian Elliott
Lisa Maher 

ASHM Staff Members who are members of these Cluster Groups
Scott McGill, Karen Seager, Bianca Leber, Kate Bath

ASHM CEO, Alexis Apostolellis



Disclaimer: This ASHM document is designed to provide available, relevant information to clinicians and other healthcare providers to optimise the health and wellbeing of people living with HIV (PLWHIV) during the COVID-19 pandemic. The recommendations provided are the opinions of the authors and are not intended to provide a standard of care, or practice. This document does not reflect a systematic review of the evidence, but will be revised to include relevant future systematic review findings of the National COVID-19 Clinical Evidence Taskforce(1) and other relevant information.