Undermining Public Health And Human Rights The United States Hiv Immigration And Travel Ban
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Transcript of Undermining Public Health And Human Rights The United States Hiv Immigration And Travel Ban
Undermining Public Health and Human Rights: The United States' HIV Immigration and Travel Ban
Jirair Ratevosian, MPHUS Field Coordinator, Health Action AIDS
CampaignPhysicians for Human Rights
Aaron C. MorrisStaff Attorney
Immigration Equality
Common Immigration Options– Non-Immigrant Visas Common visas
“Tourist” visa Visa Waiver Program Student Visa Work Visa
Visas versus admittance
Common Immigration Options – Immigrant Visas Labor Certification Diversity Visa Lottery Humanitarian Adjustment (asylum,
CRAA, VAWA…) Family Unification
Marriage (opposite-sex only please) Parents or children Siblings
Ban on immigration and travel America! Banning HIV+ immigrants
since 1987 Law versus policy
President Clinton’s proposed exec order Congress passes explicit ban in 1993
Proposed regs stalled in OMB since December
Inadmissibility
Classes of inadmissible immigrants Serious criminals; aggravated felons etc. Terra-ists and People living with HIV
Congress repeals ban in July 2008 DHS – streamlines regs HHS – edits list of diseases
HIV and Non-Immigrant Visas
No HIV test “Communicable Disease of Public Health
Significance” Question Asked 30 Day Waivers
“Humanitarian” reasons such as: attend conferences; receive medical treatment; visit close relatives, conduct business
Designated Event Waivers
“2008 Streamlining?”
In October, DHS issued new regulations for 30 day waivers
Consular officer’s “quick” decision if: Medication Private health insurance No green cards
Redundant, redundant, redundant No immigrant intent No public charge
HIV and Legal Permanent Residence Must undergo medical exam Must qualify for waiver
Either with qualifying relative or As asylee/refugee
Absent a qualifying relative, no green card For employment based applications For diversity visa lottery winners
You qualify for a waiver if you are: The spouse or unmarried son or daughter of a
USC or LPR The minor unmarried lawfully adopted child of a
USC The parent of a son or daughter who is a USC
or LPR Self-petitioning VAWA spouse or child Missing relatives:
Married son or daughter of USC Sibling of USC
Other HIV Waiver Requirements Form I-601 (and fee $545) Demonstrate the danger to public health of U.S.
is minimal Demonstrate that possibility of spread of
infection is minimal Demonstrate no cost incurred by any agency of
U.S. government without prior consent of agency = private insurance Special problems for consular processing
Public charge separate but related issue
Insurance strategy for family cases File adjustment application w/ EAD
application “Window period” during which applicant
can work Get job w/ insurance or Add to family member’s insurance
ADAP as supplement (not enough on its own) to cover pre-existing condition
Other insurance possibilities? Blue Cross Blue Shield Travel insurance Clinical trial program Government is already paying for
healthcare
HIV and Naturalization
No HIV ground to deny naturalization application
No public charge issues for naturalization Possible to have fee waived for
naturalization application (except for finger prints)
Possible HIV-related waiver of English/civics requirement
Permanently Residing Under Color of Law (“PRUCOL”) Not defined in U.S. immigration law Definition used in benefits law – “known to
DHS, DHS is not taking steps to deport him/her” Examples:
Extended voluntary departure (eliminated after 1996)
Deferred action Some pending applications
But receipt of benefits may be a problem for some applications
Not Temporary Protected Status
Travel Restrictions in the Global Context
Slide borrowed from David Hans-U. Haerry, European AIDS Treatment Group
Categories of Restrictions
Countries without restrictions Countries with entry bar Countries with short term restrictions
For stays less than 90 days, require disclosure of HIV status for short term stays OR demand mandatory HIV testing for short term stays
Countries with long term restrictions for stays longer than 90 days, required disclosure of status and HIV
testing when applying for such a permit Countries with contradictory information
Information received from various sources is either contradictory, not conclusive, or it relates only to particular groups or regions in the country
Countries without information
Global Context: HIV related travel & residence regulations
68
21
96
1268 - restrictionsconfirmed
21 - informationcontratictory, restrictionspossible
96 - no restrictions
12 - no informationavailiable
Slide borrowed from David Hans-U. Haerry, European AIDS Treatment Group
•14 States deny entry or require status disclosure even for short term stays•30 countries deport HIV+ foreigners
Name & Shame (2008)
Countries with restrictions Andorra, Armenia, Belarus, Bulgaria, Cyprus, Georgia,
Germany, Greece, Hungary, Israel, Kazakhstan, Lithuania, Moldova, Poland, Romania, Russia, Slovakia, Tajikistan, Turkey, Turkmenistan, Ukraine, Uzbekistan, USA
8 countries bar entry for any reason/length of stay
Brunei, China, Oman, Qatar, South Korea, Sudan, UAE, Yemen.
5 countries deny ST visa (10-90 days) Egypt, Iraq, Singapore, Tunisia, Turks & Caicos
Islands
Deportation - 30 countries
Bangladesh: likely if authorities know serostatus. Hungary: possible if advised by authorities. Jordan: recorded cases of Africans. Korea (North): reason no treatment. Kuwait: immediate; no entry with HIV. Malaysia: possible by law, applies to migrant
workers. Qatar: immediate; incl tourists. Russia: recorded by NGOs, people with HIV have 3
months to leave.
How are restrictions justified?
People with HIV a danger to public health spread the disease a burden for society & health care budgets (medical migration, poor health care system) short life expectancy, not contributing to society HIV comes from outside & we can stop it at border
Does this reflect reality in 2008?
25 years in the epidemic, we know:
HIV is not highly contagious, transmissions are due to specific behaviours (target for intervention)
Safer sex and safer use are everybody’s responsibility
Screening at borders: wrong message, undermining public health efforts on HIV prevention & care.
People facing restrictive measures will hide status, avoid HIV testing & care services.
Statements on public health issue 1987 WHO expert consultation: “no
screening programme of international travellers can prevent the introduction and spread of HIV infection”.
1988 WHO statement: “HIV screening of international travelers would be ineffective, impractical and wasteful…Rather than screening international travelers, resources must be applied to preventing HIV transmission among each population, based on information and education, and with the support of health and social services”.
2008 International Task Team on HIV-related Travel Restrictions:
“There is no public health rationale for restricting liberty of movement or choice of residence on the grounds of HIV status. […] Therefore, any restriction on these rights based on suspected or real HIV status alone, including HIV screening of international travellers, are discriminatory and cannot be justified by public health concerns.”
Source: Susan Timberlake; Senior Human Rights and Law Adviser, IAC Mexico 2008
Recommendation: Drop restrictions based on public health concerns Although infectious, HIV cannot be
transmitted by the mere presence of a positive person or by casual contact
Transmitted through specific behaviors which others can protect against
Restrictive measures may actually undermine prevention and therefore public health efforts
Global Effort to overcome restrictions Overcome perception that these protect
public health Overcome ignorance, stigma and
discrimination that informs restrictions Ensure equal access to mobility Ensure entry, stay, residence regulations treat
HIV same as comparable health conditions Support dialogue and joint action by health
officials and immigration/justice officials Expand HIV prevention, treatment, care and
support in sending and receiving countries
Students and Health professionals helped reauthorize PEPFAR
Student chapters mobilized Deans and faculty to submit comments during December 2007 public commenting period
In the critical final weeks and days of the reauthorization process,
thousands of students and health professionals
repeatedly called and wrote and met with targeted
legislators to provide them with essential facts about HIV
Travel ban
Students kept AIDS in the media
What can students and health professionals do? Raise awareness
Reach out to media to cover the issue
Speak out during Public Commenting Period for HSS (stay tuned!)
Write a Letter to the Editor
Keep it short and sweet Pick one or two points that most resonate
with you and expand Include the title of the article
Ex. In response to “Obama Repeals Travel Ban”(1/19), the article fails to mention other steps needed to address the feminization of AIDS.
Include your contact information Identify yourself as a member of PHR Student
Chapter Email the letter to the Letters Editor
Call/email to follow-up
Database www.hivtravel.org