US Travel Ban on HIV-infected Individuals

Welcome to this installment of The AIDS pandemic, a podcast hosted
by Dr. David Wessner from the Department of Biology at Davidson
College. I’m Middleton Chang.

Since 1987, the United States Department of Health and Human
Services has imposed a travel ban on HIV-infected individuals,
under the premise that HIV falls into their list of “dangerous and
contagious” diseases which present a public health risk. The law
specifically prohibited foreigners from immigrating or obtaining a
travel visa to the United States. Activists had long decried the
ban for several reasons, until this past summer. On July 30, 2008,
President Bush signed into law a five-year, $48 billion bill to
fight AIDS, malaria and tuberculosis around the world as well as
lift the ban on HIV positive travelers. Yet the ban has still not
actually been lifted. HIV/AIDS activists, at first praising the
current administration are becoming impatient for an actual removal
of the ban.

HIV/AIDS activists originally declared the ban to be unnecessary
and unfair. The ban was not codified into law however until 1993
during the Clinton Administration, much to the chagrin of
activists. This legislation made HIV the only specific medical
condition mentioned as grounds for inadmissibility to the United
States. Activists argue that the ban was just another in a long
string on US inconsistencies on HIV/AIDS policy. Helene Gayle,
president of CARE, stated that the ban was not consistent with the
international leadership role the United States has taken with
PEPFAR (President’s Emergency Plan for AIDS relief). Experts at the
International AIDS conference this past fall were full of praise
for the new legislation lifting the travel ban. However, little has
been done to actually lift the ban. In order to do so, the
Department of Health and Human Services must write a new rule,
submit it for public comment, and finalize it. The Bush
Administration has moved with the speed of a rolling stone
gathering moss on this issue. Last week 58 house Democrats
submitted a letter to President Bush urging “swift action” on the
issue.
Due to the ban, no major AIDS conference has been held on US soil
since 1993 as no activists or researchers infected with the virus
may enter the country without embarking on a complicated waiver
process. In 1991, 40,000 Haitian political refugees fled to the
United States. Of these refugees, 158 were detained in Guantanamo
Bay, Cuba due to the ban. For nearly twenty months, Guantanamo Bay
hosted these 158 political refugees, due to either being
HIV-positive, or a relative of one of the positive refugees. A
court order was needed to force the Clinton Administration to close
down the razor-wire encircled refugee camp setup in 1991 by the
Bush Administration.

Despite the fact President Bush has signed the bill mandating
removal of the ban into law, HIV remains on the list of “dangerous
and contagious” diseases that may prevent entry into the United
States. Recently, the Department of Homeland Security released a
revised and “streamlined” process for obtaining a waiver, making it
easier to obtain the necessary paperwork. However, the Department
of Heath and Human Services has still not removed HIV from the list
of medical conditions which are grounds for exclusion from entering
the United States.

A study conducted in 2006 showed that of 1113 HIV positive survey
respondents. 349 (31%) had traveled to the United States. Of those
349 that had traveled to the US, only 14.3% traveled with the
mandatory waiver to obtain a travel visa. Many simply did not
disclose their status. This study not only shows the inefficacy of
the travel ban, but shows the harm presented to HIV positive
individuals who desire to visit the United States. The study showed
that patients on anti-retroviral therapy (212 patients) were more
likely to go off their medication, increasing their chances of
developing drug-resistant HIV strains or developing AIDS. The study
concluded that people do so “with insufficient planning and
advice.”

Only about a dozen countries around the world maintain a travel ban
on people living with HIV. These countries are: Iraq, China, Saudi
Arabia, Libya, Sudan, Qatar, Brunei, Oman, Moldova, Russia,
Armenia, and South Korea. Should the United States still include
itself amongst these countries in discriminating against people
living with HIV?

Thanks for listening, until next time I’m Middleton Chang.

For more information:
Mahto M, Ponnusamy K, Schuhwerk M, Richens J, Lambert N, Wilkins E,
Churchill DR, Miller RF, Behrens RH. “Knowledge, attitudes and
health outcomes in HIV-infected travellers to the USA”. HIV
Medicine 2006; 7: 201–204.


"Give me your tired, your poor,
Your huddled masses yearning to breathe free,
The wretched refuse of your teeming shore.
Send these, the homeless, tempest-tost to me,
I lift my lamp beside the golden door!"
-An excerpt from The New Colossus, which hangs within the Statue’s
Pedestal.