HIV and the UK CAA

[student88]

A British man has been prevented from becoming a commercial airline pilot because he is HIV-positive, BuzzFeed News can reveal.

The man trying to obtain his licence, whom we will refer to as Anthony to protect his anonymity, has accused the UK's Civil Aviation Authority of discrimination and told BuzzFeed News its actions have “destroyed a boyhood dream” of becoming an airline pilot.

The CAAs attitude towards HIV needs to change.

The Buzzfeed article
(https://www.buzzfeed.com/patrickstrudwick/a-british-man-has-been-prevented-from-becoming-an-airline?utm_term=.vsYoDa126#.qjj0ZJe7y)
The Sun article
(https://www.thescottishsun.co.uk/fabulous/1957648/glasgow-man-civil-aviation-authority-pilot-hiv-easyjet/)

[Fostex]

Whilst HIV might have been a genuine reason not to grant a Class 1, 10-20 years ago, it isn't today. Nowadays any risk is going to arise from the drug therapy in use rather than the underlying pathology.

The 'CAA's attitude', as the article points out, is of course dictated by EASA. Also interesting to see that the old OML and 1% rule comes up again.

"The reason pilots with HIV have to have an OML is because, he said, “the best-case scenario of risk that they are able to state [on the data being used] is you have a 0.5% chance of incapacitation.”But in order to fly solo and not need the limitation on the medical certificate pilots have to be considered to have a risk of incapacitation of 0.1% or less."


I would love to know how that risk is actually calculated statistically, in fact I would love someone to legally challenge it.

[Radgirl]

I see this issue has also been aired on other threads so my take on it:

the good news is that if you take retovirals before exposure or within an hour of exposure you do not get infected - there is pressure to provide this prophylaxis called PREP in the UK but it is up to politicians not scientists so expect the usual incompetence.

Even if you become infected retrovirals, taken for life, should give you a normal lifespan without medical issues

but here comes the problem for the regulator. Most people who have HIV didnt take PREP initially. They were infected for a period before they received treatment. The possibility exists that they may have developed some problems or may develop them in the near future.

In addition there is a risk the individual may stop their retrovirals. In the US less than half HIV positive people take them due to cost. Pilots may run out especially if flying long haul. etc etc

And all these risks can not only result in incapacitation but worse mental health issues including psychosis. This can lead to untruthful medical declarations etc etc.

It is an impossible position unfair on some pilots.The irony is that we should have eradicated new cases. If 95% of those who are HIV positive took retrovirals the epidemic would end but in the UK we fail to test enough people (those we test positive we do treat) and in the US they test enough but far too few take retrovirals. An epidemic the scientists can stop but the politicians cant.....

[student88]

Is it conceivable for someone to hold a class 1 without having conducted any flying training, to then 12 months later have a restriction applied to their medical, to then begin pilot training and gain successful employment as a pilot?

I don't understand why the authority are unable to issue an initial class 1 with a restriction.

I would love to know how that risk is actually calculated statistically, in fact I would love someone to legally challenge it.


Me too. Fatigue offers more risk to day-to-day operations than a pilot with HIV, but the CAA don't seem to care too much about that problem.

[Radgirl]

Fatigue offers more risk to day-to-day operations than a pilot with HIV,

Sorry, dont agree. and anyhow crew duty hour regulations are designed to prevent fatigue

[student88]

Yeah, ok! Meanwhile in the real world..

[gingernut]

The bottom line here, is, will having HIV suddenly incapicitate a pilot ?

I've not heard of any 747's falling out of the sky yet.

Most patients with HIV (in the UK), will die of the usual stuff, heart disease, cancer, and fragility.

[Radgirl]

Agreed Gingernut, but I suspect the 2 issues of concern are pneumocystis (I have seen patients go from a bit of a cough to collapse in less time than a long haul flight) and cerebral issues leading to psychosis. Both would be a no no and far more concern to a doctor than fatigue. Even if you can prove fatigue caused an accident, you blame the legislators. If it were HIV you blame the doctor who signed the pilot off.

I would hope that pilots who have been clear of complications for a period of time on retrovirals and who have a low viral load could in the future be reconsidered, as my understanding is that they are near zero risk compared with HIV positive patients with complications, off retrovirals and with a high load

However, the regulator seems to be treating risk in this case as if it were 1995 not 2017. We know they take ages to catch up with modern medicine because they are not obliged to change and want to avoid repercussions....

[gingernut]

I think the technical term is "stigmatising."

[musti1]

The page on CAA's website regarding the requirements has disappeared. Instead, there is one page that has a few paragraphs of very general information. Does anybody know if the requirements have changed?

[himo]

Can you give the link of the page?

Thanks

[musti1]

Being a new member, I am not permitted to post website links yet so I will try to guide you:

It used to have its dedicated page with a long list of requirements (page is no longer there), the website link was mentioned by Flyin'Dutch' on this forum under the thread number 409787 if you can retrieve it. An archived snapshot by a third party site from July 2018 can be found online...

Currently the only information about it is covered by a few general paragraphs, if you search "CAA HIV" on Google it should be at the top of the page...

I am just curious to know if the CAA decided to simply hide it for some reason or if there has been any change in the requirements...

[Sepp]

musti1 Was it this page (https://www.caa.co.uk/Aeromedical-Examiners/Medical-standards/Pilots-(EASA)/Conditions/Infectious-Disease/Infectious-diseases-guidance-material-(GM)/) you were referring to?

(Apologies to grammar freaks, it's been a long day)

[Radgirl]

Surely this is good progress. It doesnt seem to recognise that retroviral therapy can effectively suppress the disease because it demands ongoing reassessment in all positive pilots, but with a helpful consultant or two it means you can keep a license. Keep the pressure on and they may in future remove the OML which does seem illogical in those with no history of active disease, on retrovirals and with a low load

[musti1]

Thanks for the link, Sepp.
It is indeed the the current and only information that can be found on CAA's website.
Compared to the previous version (if I can call it that), quite a few requirements are not mentioned such as:
- Neuropsychological assessment
- additional blood tests such as for lipids and of fasting glucose
- annual cognitive function assessment
- and perhaps more importantly it doesn't mention what they mean by "frequent". Current national medical guidelines recommend blood tests once every 6 months once the person is under effective treatment (undetectable viral load and good CD4 count). The previous CAA requirements however, wanted every 3 months, which meant a private visit to a consultant to complement the usual ones...

I suppose a question to the CAA medical team might clarify what exactly they want. In the mean time if anyone is going through this process they are welcome to drop me a PM.