UK Doctor: ‘I’d Rather Have HIV Than Diabetes’

Posted on May 8, 2014 in Chronic Disease, Medical Rewind

A U.K. doctor has stirred up controversy after writing an op-ed in the U.K. paper The Spectator where he argued that he’d “rather have HIV than diabetes.”

Dr. Max Pemberton, author of “The Doctor Will See You Now” and who works in mental health, wrote the article to highlight how having diabetes, particularly Type 2 diabetes, can be thought of as “worse” than being HIV-positive, which is now often treated as a chronic, and not necessarily fatal, disease.

“The risk of stroke in newly treated type 2 diabetes is more than double that of the general [U.K.] population,” Pemberton wrote in his article. “To put it starkly, the latest statistics show that because of Haart (Antiretroviral medications), HIV now no longer reduces your life expectancy, while having type 2 diabetes typically reduces it by ten years. But this isn’t an easy thing to say publicly.”

Pemberton highlighted facts such as the life expectancy in the U.K. for those with HIV is only minimally lower.

However, at least one expert says that Pemberton’s argument does a disservice to both diabetes and HIV, by arguing that one life-threatening disease is “better” than another.

Dr. Kenneth Mayer, professor of medicine at Harvard University and medical research director at Fenway Health Clinic, which provides primary and specialized HIV/AIDS care, noted the two diseases are very different in how they are acquired and treated.

“My whole point [is it] shouldn’t be either or. They’re both important,” said Mayer. “There may be more people at risk for diabetes [globally], but HIV is transmissible,” between people.

Pemberton could not be reached immediately by ABC News for further comment.

One important distinction, experts said, is that Pemberton is speaking as a U.K. citizen. In the United Kingdom, HIV affects far fewer people than in the U.S., with approximately 77,600 people infected in the U.K. versus approximately 1.1 million in the U.S., according to the Centers for Disease Control and Prevention, and the U.K. National AIDS Trust.

However, not every expert completely disagreed with Pemberton’s article.

Dr. Joel Gallant, chair of the HIV Medical Association and medical director of specialty services at Southwest Care Center in Santa Fe, N.M., said the statement is not preposterous if you look at how effective HIV/AIDS medications are today in comparison to the treatment options for diabetic patients.

“I wouldn’t want anyone to interpret my words as wanting to have HIV. … We don’t know, for example, that a person with HIV, even very well controlled, is going to have the same exact quality of life as someone without it,” said Gallant. “Nobody should think of it as a non-issue [but] as chronic diseases go the treatment for this is better than most.”

But Mayer said it’s important the articles such as Pemberton’s don’t make people complacent about the status of HIV treatment in this country or globally.

“I’m not very happy with the article. I think comparing two serious illnesses is not very useful,” said Mayer, who explained there are still many hurdles towards treating people with HIV in the U.S.

Although Mayer concedes Pemberton’s point that medications have made HIV very manageable, he said it has been difficult to effectively diagnose people who have the disease.

According to the CDC, about 25 percent of people with HIV are successfully keeping their virus under control through medication. Worldwide, fewer than 11 million people are being treated while more than 35 million people have the disease, according to UNAIDS.

Rates of HIV infection in the U.S. have remained about the same since around the mid-1990s at about 50,000 new infections every year, according to the CDC. And according to a 2011 CDC report, there are still around 15,000 deaths from HIV/AID in the U.S. every year.

Mayer said approximately 20 percent of people with HIV in the U.S. do not realize they are infected with the disease and it can be years before they show symptoms. Additionally, while medication has been shown to help keep the disease in check, experts are concerned about the effects of long-term use.

“That again is why I’m not so thrilled about the article,” said Mayer. “We don’t know what long-term consequences of HIV combined with aging. HIV might lead to higher risk of cardiovascular [complications.]”