HIV testing, insurance, and mortgage applications

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QuotationMarkLeft.png Insurance companies may ask the GP of an individual applying for life or permanent health insurance (income protection) for a medical report, with their patient’s consent, particularly if they have declared a medical condition on their application form. Refusal to consent to the GP giving a report will normally result in cover being refused. The GP will be required to state if their patient has had a positive HIV test or is awaiting an HIV test result. GPs are not asked to speculate about the patient’s lifestyle on the new version of the general practitioner’s report; and the ABI is consulting on making this mandatory. The BMA advises GPs not to answer such lifestyle questions. GPs should not be asked if a patient has had a negative HIV test or counselling for an HIV test. QuotationMarkRight.pngRoyal College of Physicians[1]

QuotationMarkLeft.png There are two common misconceptions regarding HIV testing that create barriers to uptake and need to be dispelled. Firstly, lengthy pre-test HIV counselling is not a requirement, unless a patient requests or needs this. The minimum requirement is to provide an opportunity for pre-test discussion to ensure informed patient consent to the test. HIV in Primary Care provides guidance on the pre-test discussion which is of general relevance to clinicians4. An information leaflet on HIV (including the HIV test), produced by the Family Planning Association for the Department of Health, is available from your local health promotion unit or sexual health clinic. Secondly, the fact that a patient has had an HIV test, if negative, does not need to be disclosed on applications for insurance (see Association of British Insurers Statement of Best Practice on HIV and Insurance[2]). QuotationMarkRight.pngDepartment of Health[3]

When AIDS and HIV were first identified, being HIV positive was considered a death sentence, and there was much anxiety about the need for counselling prior to HIV testing.

Now, HIV infection is manageable, life expectancy for people who are known to be positive has increased enormously, as they can receive appropriate treatment, and it would probably be more appropriate for HIV testing to be "normalised", and treated no differently from other tests.

There remains some anxiety based on myths that having been tested for HIV may impair a patient's ability to get life insurance or a mortgage (or at least, that it will increase their premiums). At least in the UK, insurance companies should not ask about whether an applicant for insurance has had an HIV test, only about positive tests. [4] [5] [6]

So having an HIV test does not, per se, impair an individual's chances of getting a mortgage or life insurance, or increase the premium. A patient may, however, have sought the test because they believe themselves to be at increased risk of HIV infection. Patient's might find that their insurance is invalidated if they fail to declare risk factors when asked to do so.


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