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Universal access to highly active antiretroviral treatment (HAART) has become the global standard for treating people living with HIV

Where did you first start treatments?

For people living with HIV this is now a new important question asked in a Life Insurance application.

This year 2023, will mark 42 years since the first five cases of persons with pneumocystis carinii pneumonia in Los Angeles, California – which later became known as GRID, then AIDS – were officially reported to health authorities.

Later it was discovered HIV is the virus that causes acquired AIDS, and so began the medical quest to stop HIV replication from person to person that continues today.

Jump Ahead

Life, Love & Life Insurances

HIV is treated with antiretroviral medicines, which work by stopping the virus from replicating in the body. This allows the immune system to repair itself and prevent further damage. A combination of HIV drugs is used because HIV can quickly adapt and become resistant.

  • The treatments are effective when they are taken and consistently available for use.
  • This accessibility to treatments issue is often referred to as ‘Universal Access

In recent years demand for antiretroviral treatment has increased due as a better understanding of the clinical importance of early treatment.

Universal Access to Treatments - but not yet for everyone

Universal health coverage is part of the strategy to contain the HIV epidemic since we need to deliver treatment to everybody.

So, in principle, all countries have agreed to provide free access to treatment, but the access is very different from country to country. The organization of health systems is a major issue and generates inequalities in terms of access to treatment. Professor Autran, Director of the Immunology Department and the Medical Biology and Pathology Hub at the Pitié-Salpêtrière Hospital in France

The problem is global investment in HIV treatments has declined and this means some governments around the world struggle to provide universal access to treatments (or stability of their supply) to their citizens. When those citizens migrate to Australia, their health history is naturally different from those people who do enjoy universal access to treatments.

As access to HIV medicals and treatments became a UN recognised human rights issue, the Standard of Universal Access to Treatment, became increasing the standard by which Life insurance companies began to measure risks to people living with a positive diagnosis.

Different standards, different countries, different reasons

There are 48 separate countries, predominantly Sub-Saharan Africa & South America regions with unstable access to HARTS tri-therapy - and since 1996 has been sporadic with country coverage and availability between only 50-80% of the population

This has an impact on the quality of an individual's health and ultimately how their level of risk is later assessed for life insurance coverage.

How Univeral Access Affects Life Insurance Underwriting Standards

Universal access to Highly Active Antiretroviral Therapy (HAART) treatments is defined broadly as a high level of access (80% or more of the eligible population) that is accessible and affordable. It does not necessarily mean 100% coverage. - UN source

Universal access to highly active antiretroviral treatment (HAART) has become the global standard for treating people living with HIV and achieving epidemic control; yet, findings from numerous 'test and treat' trials and implementation studies in sub-Saharan Africa suggest that bringing 'universal' access to HAART to scale is more complex than anticipated. Source

How Univeral Access affects an application for life insurance

For people living with a positive HIV diagnosis, where you were first diagnosed and where you first began treatments matters.

  • Many of our clients originate from different regions of the world and for those originating from Sub-Saharan Africa and the South Americas, there are over 48 different countries with different levels of consistency complying with Universal Access.
  • Therefore, some people from regions different from Australia may be at higher risk of initial treatment interruption or even reduced early availability to effective HARTS medications, and this can take a toll on their overall health.

This is why we have updated our anonymous pre-assessment

In November 2022 Unusual Risks Insured updated our online anonymous pre-assessment criteria to add two new questions about your experience with accessing early treatments and Universal Access.

  • Were you first diagnosed HIV-positive outside of Australia?
  • And if so, to specify which region.

Sample from our new 2023 Anonymous Pre-assessment

The Good News

The answers to these questions only change the level of risks an insurance company has to manage (and the cost of the insurance premiums they need to charge for a policy). It does not mean cover is automatically declined for those for regions outside Australia, just that their insurance policy premiums may be higher.

The Very Good news really is that people living with HIV in Australia now can qualify for full personal insurance protection - and Unusual Risks Insured are the experts at helping Australians with complex health histories or hard to insure occupations, get their life insurances sorted.

Treatment has really revolutionised HIV infection. We have gone from an infection that killed every patient, with almost 100% or 99.99% mortality, to almost zero mortality if the treatment is taken properly. And we know that the survival of patients with good treatment is normal. Professor Brigitte Autran . Prof. Autran is leading the "Immunity and Immunogenetics against Virus and Vaccine" research team at the Pitié-Salpêtrière Hospital in Paris, France. SCORE RE December 2, 2019

A personal note from Our Founder and Senior Financial Adviser, Drew Browne

In my 20-plus years in insurance, Unusual Risks Insured have been lucky enough to witness, and even take part in, the huge strides made in improving insurance access to people living with HIV. Just 20 years ago, the life expectancy of an individual with HIV looked very different – and so did their prospect of obtaining Life Insurance and Income Protection cover.

Today, thanks to modern medicine, not only is HIV a manageable, chronic condition but it is also proving to be one that one day will be cured.

The noble mission of Life Insurances supporting people during a vulnerable time in their lives is why I joined the life industry in the first place.

Pushing the boundaries of what we thought was possible and working to make insurance fairer and more inclusive for all Australians, is why I'm staying. — Drew Browne Founder Unusual Risks Insured

Happy Sydney WorldPride 2023, Australia!

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Unusual Risks Insured provides support to those people who big insurance companies leave behind. We believe in giving every person the power to use life insurance products to protect & provide for their loved ones, their businesses, and their legacy — free from barriers of stigma and discrimination.

We know, as an LGBTQIA+ person (or someone who goes without labels entirely), you probably have specific financial advice, life insurance, and privacy needs.

  • We're committed to serving the LGBTQIA+ Community and its Allies.
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Why not make us part of your story, so if the unexpected happens to you or whoever is family to you, you'll have a backup plan in place to help you financially recover and life can still get better for somebody you love.

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Drew Browne, Senior Advisor

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