COVID-19 and HIV/AIDS: The Accessibility of Harm Reduction at VOAFIT

by Lucia Burton

“We are living in a time of two intersecting global pandemics — HIV and COVID.”

— Valerie Farsetti, VOAFIT Program Manager

HIV/AIDS has deeply affected millions of people for decades. The stigmas associated with the disease have further marginalized communities, targeted education of sexual health, and created countless barriers to basic healthcare.

Volunteers of America Friends Inspiring Testing (VOAFIT) is a program that identifies and tests individuals who are at high risk for infection and do not know their HIV status, thus increasing awareness, accessibility, and reducing such stigmas. In a pre-COVID world, VOAFIT saw about 680 tests every quarter — 2,720 tests per year — through outreach programs. Their presence in the community was vital to the health of many.

In March 2020, though they were not immune to the impact of COVID, VOAFIT was able to keep meeting some needs of the community: with a temporarily closed testing location, they still successfully provided safer sex supplies and held virtual programming. While they were not operating at optimal capacity, they were able to continue providing relief to those who rely on their services.

In June 2020, VOAFIT reopened their testing location and started the process of regaining traction in providing STD/HIV tests. Fast forward to February 2021, and their numbers are still incredibly low; around a fraction of what they were pre-COVID. According to Valerie Farsetti, Program Manager at VOAFIT, the reasons for this are many, multi-layered, and intersecting.

Some factors are obvious: we are still in the midst of a pandemic, thereby not allowing for community events — which VOAFIT uses for education and awareness — that would subsequently attract large gatherings of people. There are reduced capacity limits in buildings, lowering the amount of people who can get tested within a reasonable amount of time.

Many people are hesitant to leave the safety of their home, which would put them at risk of exposure to COVID-19. Lastly, there are the usual barriers to HIV testing that have not gone away, such as lack of transportation, knowledge of the testing site, let alone the stigma that people who get tested must face.

However, some other factors are not as blatant: while we are already in the midst of an HIV/AIDS pandemic and a COVID pandemic, the latter has catapulted the collective society into a mental health pandemic as well. Billions of people suffer from depression, fear, loneliness, and anxiety (and many other mental health battles) that have gotten exponentially worse during the past year. Along with mental health barriers, Farsetti suggests that there is shame in a person admitting that they have been “out & about” — engaging in activities that would lead someone to need to get tested (such as sex and injection-based drug usage), during a time where the moral expectation is to self-isolate to decrease the spread of COVID-19. Finally, all of these factors are disproportionately magnified in BIPOC, disabled, and queer communities. 

Up against all of these sources of inaccessibility of HIV testing is the new pressure to take care of our health and be hyper-aware in ways many have never been before. Sexual health does not fall outside of this pressure. The reality is that people are having unprotected sex, using injection-based drugs, and participating in other activities in which contraction of HIV/AIDS is possible. However, the same people are unable to, or averse to, getting tested because of the reasons outlined above. Simply not knowing your HIV status increases the possibility of spread.

While many of the problems that VOAFIT is currently facing are due to the COVID-19 pandemic, one way that a person can take care of themselves is by vaccination. Alee Allemann, an HIV Educator at VOAFIT and an HIV+ individual, has received the vaccine with minimal side effects. According to Allemann, the vaccine did not affect her any worse than others who have also received the vaccine who are not HIV+.

With her first dose, she only experienced a sore arm, like many already have. After her second dose, she had a low fever, fatigue, and chills the day after vaccination, another common response. The following morning, those side effects were gone. The only difference in symptoms she felt from others is the “COVID arm,” when the vaccination site is sore, red, and itchy. Generally, “COVID arm” occurs 5-7 days after injection. In Allemann’s case, “COVID arm” appeared the day after her second dose and subsided after four days. 

While we will potentially feel the effects of COVID-19 for decades, VOAFIT — and other organizations centered around harm reduction, the destigmatization of sexual health, and increasing HIV/AIDS awareness and education — continuously provide support to those who need it the most through HIV testing, distributing safer sex supplies, education via virtual programming, and many other resources. While the future is uncertain, vaccinating oneself (HIV+ or not) against COVID-19 can be the first step of many in not only protecting yourself and others, but in also allowing vital support systems, such as VOAFIT, to function and thrive in ways that are needed the most.