In late stages of HIV infection, the disease itself or adverse side effects of the medication may result in neuropsychiatric defects. These in turn might lead to incapacitation of pilots (sudden inability to pilot the plane safely), especially in the hypobaric environment prevailing during a flight. Although routine testing for HIV infection is not required by the JAR-FCL or performed by airlines, there are statutory regulations for dealing with HIV-positive pilots which apply in Europe. In the current investigation, a questionnaire was sent to the JAA National Aviation Authorities. The results revealed that the prevalence of HIV-positive pilots in Europe is very low. HIV-positive pilots have not been involved in accidents or incidents. Roughly half of HIV-positive commercial pilots and 20 % of HIV-positive private pilots are certified as fit to fly. The small number of HIV-positive pilots does not permit a statistically valid statement about the risk. Nonetheless, it seems likely that the provisions for dealing with HIV infection in Europe ensure a sufficient level of safety and safeguard against the risk of incapacitation of pilots with known or unknown HIV infection.
