Burden of COVID-19 among people living with HIV in Ontario

The COVID-19 pandemic has shown that certain members of our society may be at higher risk for severe disease. One such group is people living with HIV. HIV affects the immune system's ability to respond to infections and shares some of the same risk factors as COVID-19, such as older age, comorbidities, and lower income. So far, people living with HIV who are taking medications to control their HIV infection seem to get infected with COVID-19 and become hospitalized at similar rates to the general population, but evidence in this area is mixed and more research is needed as the COVID-19 pandemic continues to evolve. Because of limited testing and surveillance gaps, we do not yet know how many people living with HIV have been infected with COVID-19 or whether they will have more severe illness than people who do not have HIV. We will use an existing study of about 4,000 people living with HIV who are receiving care in Ontario to fill these gaps. People living with HIV will be invited to collect a finger prick of blood at home. Blood samples will be tested for antibodies to SARS-CoV-2, the virus that causes COVID-19, to see how many people have been infected since the start of the pandemic and whether these antibodies will protect against re-infection. Through linkage to laboratory, hospitalization, and death certificate records, we will find out how many people living with HIV have a lab-confirmed COVID-19 diagnosis or develop more severe illness from COVID-19. We will compare these findings to HIV-negative individuals in Ontario. Through linkage to doctor's visits, we will see how the COVID-19 pandemic has impacted medical care for HIV. Finally, if a COVID-19 vaccine becomes available during our study period, we will also measure vaccine uptake and antibody response to vaccination. These findings will inform health care and health services planning for people living with HIV.