There are currently about 33.2 million people worldwide living with HIV. The Health Protection Age...
There are currently about 33.2 million people worldwide living with HIV. The Health Protection Agency (HPA) has just published its UK figures for 2006 showing an estimated 73,000 adults suffering with the virus, of whom 21,600 are undiagnosed. But while some of them may want to buy life insurance, in the UK they cannot.
In Holland, insurance for people with HIV has been available for some time, with a group of around 3,500 HIV residents being studied since 1995. All of them were receiving highly active anti-retroviral therapy (HAART). The data collection and modelling was carried out by the HIV Monitoring Foundation - a partnership between those with HIV, those treating and monitoring the condition and those who use the data to calculate premiums. No such arrangement exists in the UK. And it is time the insurance industry, the Department of Health and the NHS set one up.
There are five variables that have a big impact on mortality: the number of CD4 cells (CD4 count), the most recent CD4 count, the most recent viral load, when the treatment started, and the diagnosis date. People diagnosed late are 13 times more likely to die within a year. Age may be a factor, but there is limited data on the over-55s.
In the UK, the data shows that the number of new diagnoses is stabilising - 7,800 in 2006 compared to 7,900 in 2005. About two fifths of diagnoses come from people who acquired HIV in the UK, while most of the rest acquired it when living in high HIV prevalence African countries. Turning to the rest, gay men form the vast majority, although there is a small but growing group of mainly black ethnic minority people who acquired it in the UK heterosexually.
Overall, about 70% are on HAART treatment. The HPA also published crude mortality data, which showed (for all but intravenous drug users) a reduction from 4.7% in 1997 to 0.95% in 2006.
For those diagnosed early and responding to treatment, the situation is very different to what it was 10 years ago and experience in Holland shows that life insurance could be available to some of them. We are now at a point where the current "ban" is indefensible. Some point to future uncertainty, but the solution is to review mortality for the insurable group periodically and adjust premiums accordingly.
The Disability Discrimination Act now covers HIV and only allows insurers to discriminate if it is evidence-based. For some people with HIV it does not seem to stack up and a court case is only a matter of time.
Richard Walsh is managing director of SPPR Consulting
