Certain restrictions on HIV-infected healthcare workers are to be lifted. Richard Walsh reports.
Changing attitudes to people with HIV takes time, but occasionally we hit a tipping point when previous positions held by society and the insurance industry become unavoidable. This last happened for life insurance. We are now at another one: the availability of individual income protection insurance.
In 2009, the National AIDS Trust published a survey of the employment experience of people with HIV. Over half said living with HIV had no impact on their working life. Almost half used existing flexibility in their job to attend HIV clinics. Indeed, 9% used their annual leave entitlement to attend clinic appointments.
There was no significant difference in the number of days sick leave HIV positive men took compared with HIV negative men for non-HIV-related illness. 70% of HIV positive men had taken no HIV-related sickness days in the last 12 months. HIV is also covered under the Equality Rights Act as any other long-term medical condition or disability, but there were some restrictions and a really talismanic one will now be removed.
In December 2011, the Department of Health published a consultation paper proposing that management of HIV-infected healthcare workers – excluded from performing clinical ‘exposure-prone procedures’ – should be amended so as to lift the restriction, provided that workers were on effective combination antiretroviral drug therapy, with a very low or undetectable viral load and were regularly monitored.
This August, the Chief Medical Officer announced that from April 2014, HIV-infected healthcare workers will be allowed to undertake EPPs, provided the above conditions are satisfied. The statement points out there is no record of any patient ever being infected through this route in the UK. There have been just four cases reported worldwide, with the last more than a decade ago.
People will also be able to buy HIV self-testing kits once the kits comply with regulations. This will give more choice on how to get tested and therefore get treatment earlier, which will reduce the risk of new infections. Because of the stigma attached to HIV, half of HIV infections are discovered late and are harder to treat.
We know people are already buying poor-quality self-testing kits online. All kits will be subject to strict regulatory control by the Medicines and Healthcare Regulatory Authority before they are authorised for sale.
So what does this mean for IP? There will be increasing numbers of people working with HIV, which, for many, will have no impact on their capacity to work; more people will be tested, with infection caught early to give the best chance of effective treatment; and the evidence base for the reasonable discrimination allowed under equality legislation will for many not be there. It is time for insurers to step up to the plate, as happened with life insurance.
Richard Walsh is a director and fellow of SAMI Consulting, www.samiconsulting.co.uk
Thursday 12 March
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