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 FALL 2008

 HIV Center E-Newsletter: Volume 2, No. 2 

• MAC AIDS • Training • Mourning Losses • Newsbriefs • From the Director • Voice of the Community •

voice of the community

Undermining Public Health and Human Rights:
The US HIV Travel and Immigration Bar

by Nathan Schaefer, M.S.S.A.

Since 1987, the United States has barred HIV-positive foreigners from entering the country. The bar was enacted with pressure from Conservative lawmakers led by the late Senator Jesse Helms. The HIV entry bar has prevented thousands of HIV-positive foreigners from acquiring legal immigration status and even short-term tourist or business visas.

 In May 2006, GMHC convened a roundtable of advocates, activists, scholars, human rights workers, lawyers, and policy workers from around the world to strategize about lifting the immigration and travel ban on HIV-positive people. The momentum generated by this event enabled the agency to spearhead the Coalition to Lift the Bar, an ongoing, working coalition dedicated to overturning this policy, including such groups as Immigration Equality and the African Services Committee

We also have convened a number of educational events to educate others about the HIV entry bar. In the summer of 2008, we hosted a satellite session against the bar at the International HIV/AIDS conference in Mexico City. We have also facilitated sessions at multiple national and international conferences, most recently at the United States Conference on AIDS and the Gay Men’s Health Summit. Finally, GMHC has published comprehensive analyses of the HIV entry bar from both a legal and policy perspective.

In the summer of 2008, the federal government finally took action to repeal the bar. Congress inserted language into the President’s Emergency Plan for AIDS Relief (PEPFAR) reauthorization bill that removed the statutory bar for HIV-positive people. Even with this change, HIV-positive foreigners have stayed ineligible to enter the country because HIV remains on a HHS list of “communicable diseases of public health significance”. Nevertheless, we are optimistic that HHS will remove HIV from that list in the coming months since officials within that agency have indicated their willingness and efforts to do so. However, GMHC and other advocates continue to push for swift removal, as the public health and human rights tolls of the bar continue to resonate.

In the meantime, the need remains for broader educational efforts. We must still clarify to the general public what the bar actually means for HIV-positive people here and abroad. There are urgent needs within immigrant populations living in the U.S. about the status of the bar, and newfound opportunities for testing and prevention interventions. And although repeal of the regulatory bar will allow people living with HIV to enter the U.S., it will not help the thousands already here who are living with HIV.

2008 proved to be an exciting year for immigration reform, public health, and the federal government’s response to the HIV/AIDS epidemic. Yet the work on fully lifting the HIV entry bar remains. We look forward to ongoing discussions about the topic, garnering support as widely as possible, and increasing our pool of advocates and resources to fully reverse this discriminatory infringement on public health and human rights.

To get involved in the Coalition to Lift the Bar, or to learn more about the issue, please click here or contact me directly at NathanS@gmhc.org. Coalition members will be added to an email distribution list, and can participate in bi-monthly conference calls to stay informed of recent developments.

Nathan Schaefer, M.S.S.A. is Director of Public Policy at Gay Men’s Health Crisis (GMHC) in New York City.

The US Travel Bar:
Myths and Realities

There are a number of misconceptions related to how the bar actually impacts HIV-positive individuals and families, and a few myths and realities warrant clarification. 

Myth: The HIV bar prevents HIV-positive aliens from entering the U.S.

Gay Men’s Health Crisis (GMHC) estimates that the HIV bar prevents about 500 HIV-positive people from entering the U.S. each year. However, many HIV-positive people are unaware of their status or discover their status after arrival. In fact, about 300,000 immigrants enter the U.S. each year without going through immigration HIV testing sites.

Myth: The HIV bar preserves public resources

Lifting the HIV bar does not automatically grant HIV-positive foreigners entry, as they are still subject to the arduous immigration procedures experienced by all. Lifting the bar only makes acquiring legal immigration status an option for HIV-positive people from other countries. In other words, it levels the playing field and stops the discriminatory ineligibility for HIV-positive people.

Reality: The HIV bar may be perpetuating the spread of HIV.

People seeking permanent residence in the U.S. must be tested for HIV. If one tests positive, they face deportation. Fear of deportation makes people “go underground” and avoid immigration and health care systems. Without HIV testing and early detection, immigrants may pose greater threats to public health as they go untreated longer, and effectively become more infectious.

Reality: The HIV bar may be increasing dependence on public resources

HIV-positive non-citizens are unable to obtain legal permanent residence, and are often required to work “off the books”.  As a result, the government misses opportunities to collect taxes. Without jobs that provide comprehensive insurance, undocumented HIV-positive immigrants are more likely to access publicly funded health care systems. This reality, compounded by less access to preventative care, makes them more likely to access public health care systems when sicker (e.g. emergency room visits). Since these medical interventions are more dire and comprehensive, they are also more costly.