COVID-19 symptoms and SARS-CoV-2 infection among people living with HIV in the US: the MACS/WIHS combined cohort study

Gypsyamber D’Souza, Gayle Springer, Deborah Gustafson, Seble Kassaye, Maria L. Alcaide, Catalina Ramirez, Anjali Sharma, Frank J. Palella, Phyllis C. Tien, Roger Detels, Mirjam Colette Kempf, Cecile D. Lahiri, Charles R. Rinaldo, Audrey L. French, Joseph B. Margolick, Ada A. Adimora

Research output: Contribution to journalArticlepeer-review

19 Scopus citations


Background: SARS-CoV-2 infection among People Living With HIV (PLWH) is not well-described. Objective: To study COVID-19 symptoms and SARS-CoV-2 PCR-based swab testing among participants of the Multicenter AIDS Cohort Study (MACS) and Women’s Interagency HIV Study (WIHS). Methods: A telephone survey was collected April-June 30, 2020. Symptom and testing prevalence were explored. Multivariable logistic regression was used to examine the factors associated with SARS-CoV-2 positivity. Results: The survey was completed by 3411 participants, including 2078 (61%) PLWH and 1333 HIV-seronegative (SN) participants from across the US. Thirteen percent (n = 441) were tested for SARS-CoV-2 infection (13.4% of PLWH vs 12.2% of SN). Among those tested, positivity was higher in PLWH than SN (11.2% vs 6.1%, p = 0.08). Reasons for not being tested included testing not being available (30% of participants) and not knowing where to get tested (16% of participants). Most symptoms reported since January 2020 were similar in PLWH and SN, including headache (23% vs. 24%), myalgias (19% vs 18%), shortness of breath (14% vs 13%), chills (12% vs 10%), fever (6% vs 6%) and loss of taste or smell (6% vs 7%). Among PLWH who tested positive for SARS-CoV-2 DNA, the most common symptoms were headache (71%), myalgia (68%), cough (68%) and chills (65%). In multivariable analysis among those tested, the odds of SARS-CoV-2 positivity were higher among PLWH than SN (aOR = 2.22 95%CI = 01.01–4.85, p = 0.046) and among those living with others versus living alone (aOR = 2.95 95%CI = 1.18–7.40). Conclusion: Prevalence and type of COVID-19 symptoms were similar in PLWH and SN. SARS-CoV-2 infection may be elevated among PLWH.

Original languageEnglish (US)
Pages (from-to)130-139
Number of pages10
JournalHIV Research and Clinical Practice
Issue number5
StatePublished - 2020


  • COVID-19
  • HIV
  • PLWH
  • SARS-CoV-2
  • epidemiology
  • symptoms
  • testing

ASJC Scopus subject areas

  • Infectious Diseases
  • Pharmacology (medical)


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