People living with HIV (PLHIV) are a unique population because of their altered immune system and taking antiretroviral therapy (ART).   Evidence from sub-Saharan African countries suggests that, despite not having higher SARS-CoV-2 prevalence/incidence, PLHIV suffer worse COVID-19 outcomes. We measured the prevalence and clinical presentation of SARS-COV-2 by HIV status in July-2020 in Zambia.