Newspapers examine efforts, reaction to easing ban on HIV-positive visitors to U.S.

Oct 5 2008

Some HIV/AIDS advocates are "being cautious with their optimism" regarding new immigration rules for HIV-positive visitors as well as HHS efforts to remove HIV from the list of diseases barring entry into the U.S., the San Francisco Chronicle reports (Fulbright, San Francisco Chronicle, 10/2).

A law that made foreigners living with HIV/AIDS inadmissible in the U.S. was repealed in July when President Bush signed the United States Global Leadership Against HIV/AIDS, Tuberculosis, and Malaria Reauthorization Act. HHS determines which diseases are inadmissible and first placed HIV on the list in 1987. This decision was later codified by U.S. immigration law. With the statutory immigration ban now lifted, HHS is in the process of removing HIV from the inadmissibility list.

Under the new Department of Homeland Security rules, HIV-positive applicants who meet "all other normal criteria for the granting of a U.S. visa" will have the opportunity to receive a temporary, non-immigrant visa from U.S. consular offices overseas, according to a DHS statement. Under previous regulations, HIV-positive people were barred from entering the U.S. unless they received a special waiver (Kaiser Daily HIV/AIDS Report, 9/30). The new rules, like previous regulations, also require that HIV-positive visitors present proof that they are not a public health risk or that they would not create potential costs to any government agency, according to CQ Homeland Security. In addition, the new DHS rules require visitors to prove that they will have enough antiretroviral drugs and financial assets or health insurance to cover any hospitalizations during their stay. The new rules apply only to non-immigrant, 30-day visas, CQ Homeland Security reports. Homeland Security Secretary Michael Chertoff said, "This regulation significantly improves the opportunities for individuals seeking to visit the U.S. who were previously inadmissible because of an HIV infection."

According to CQ Homeland Security, HHS has not provided a timetable for the removal of HIV from the list of diseases barring entry to the U.S. (Webber, CQ Homeland Security, 10/1). However, Amy Kudwa, a DHS spokesperson, said that HHS likely will remove HIV from the list within one year, the Chronicle reports. She added that she expects the new DHS regulations to be in effect by Friday.

Reaction

"We will be very happy if they in fact get HIV completely removed from the list," Brian Moulton, associate counsel for the Human Rights Campaign, said, adding that officials "need to make the entry requirements for those with HIV the same as any other person." According to Moulton, the previous regulations were enacted at a time when people did not entirely understand how HIV is transmitted and there was hysteria surrounding the virus. "Public health officials had an understanding that it wasn't a risk to have people with HIV walking down the street, but the general public and some elected officials still had a misunderstanding," he said, adding, "Fear and ignorance drove the legislative process."

Judith Auerbach, deputy executive director for science and public policy at the San Francisco AIDS Foundation, said that the new waiver process is not what advocates want. "It is a partial solution that affects a subset of people and does not eliminate all the barriers," she said, adding, "We want all the language eliminated, the regulatory as well as the statutory. There is no grounds for it; it is a discriminatory practice" (San Francisco Chronicle, 10/2).

Victoria Neilson, legal director for Immigration Equality, said that the new visa process "continues to place a burden on HIV-positive travelers, unlike anything placed on anyone with any other disease." She added, "We're troubled that this regulation is coming out now and further codifying the HIV ban and waiver requirements just three months after Congress issued a mandate that it wants HIV removed from the list of communicable illnesses of public health significance. DHS shouldn't be focusing on fine-tuning the waiver application progress."

According to Neilson, consular officers overseas also have no method of determining during a visa interview if an antiretroviral is "medically appropriate" for an HIV-positive person or if they would engage in high-risk behavior. Joe Amon, director of the HIV and human rights program at Human Rights Watch, said the new regulations are "very indicative of the kind of stigma and discrimination that is often put against people living with HIV." He added, "People with HIV take responsibility for their behaviors all of the time, and people at-risk need to be aware and adopt protective behavior as well." According to Neilson, the new visa process would eliminate 18 days from the application process (CQ Homeland Security, 10/1).