Disability pension and sick leave in people with HIV compared with the background population - a nationwide population-based matched cohort study

OBJECTIVES: People with HIV (PWH) are unable to get private disability insurance on a regular basis in contrast with individuals with other chronic diseases. We aimed to estimate the risk of public disability pension and work absence due to sickness for PWH compared with the background population in Denmark.

DESIGN: Nationwide, population-based, matched cohort study of employed PWH with favorable disease characteristics. A comparison cohort of employed individuals was matched 10:1 to PWH by date of birth and sex from the general population.

METHODS: We computed time to first date of 4 weeks of uninterrupted sick leave, 26 weeks of uninterrupted sick leave, and disability pension being granted. We used Cox regression to obtain hazard ratios (HRs) as a measure of relative risk and competing risk analysis to assess absolute risk.

RESULTS: After 6 months of observation, PWH had an increased risk of 4-week sick leave, 26-week sick leave and disability pension compared with the comparison cohort (HR of 1.1 (95% CI: 1.0-1.2), 1.4 (95% CI: 1.1-1.6) and 2.0 (95% CI: 1.5-2.6), respectively). These risks were increased in most patient subgroups.

CONCLUSION: PWH have an increased risk of prolonged sick leave and disability pension, and a slightly increased risk of 4-week sick leave. These risks were within the range of what is described for other chronic diseases. PWH with contemporary cART and favorable disease characteristics should not be generally excluded from access to private disability insurance.