The White House has announced that it will ease – but not remove – 20 year-old restrictions barring short-term HIV-positive visitors from entering the United States. The announcement only affects people travelling on tourist and business visas that allow entry for up to 60 days, however, and does not fundamentally alter US immigration policy. It is also unclear whether HIV-positive tourists will still have to declare their HIV status to US officials to benefit under the new rules.
A White House Fact Sheet produced on World AIDS Day, headlined "The President Is Dedicated To Ending Discrimination Against People Living With HIV/AIDS", issued the following statement: “The President will direct the Secretary Of State to request, and the Secretary Of Homeland Security to initiate, a rulemaking that would propose a categorical waiver for HIV-positive people seeking to enter the United States on short-term visas."
The statement does not explain, however, how this “categorical waiver” would enable HIV-positive people to enter the United States for short visits other than claiming that it would be “a streamlined process.” Currently, HIV-positive individuals can apply for a short-term waiver to allow them to enter the US under certain circumstances. However, applying for this one-off visa waiver requires a personal interview at a US Embassy; decisions take several months, during which time your passport is kept by the US Embassy; and, if granted, the visa waiver results in a permanent – and stigmatising – passport stamp.
The ban on HIV-positive visitors and immigrants came into effect in July 1987, as part of Republican Senator Jesse Helms' infamous ‘Helms amendment’. Although the main – and devastating – focus of this right-wing fundamentalist Christian's politician’s amendment was to prevent the US government from paying for any AIDS education or prevention materials that would "promote or encourage, directly or indirectly, homosexual sexual activities," it also added HIV infection to the Public Health Service (PHS) list of "dangerous and contagious diseases," for excluding persons from entering the United States for public health reasons. President Reagan had already added AIDS – but not HIV – to the list a month earlier.
The exclusion was widely publicised following a mass boycott of the Sixth International AIDS Conference in San Francisco in 1990. In 1992 the International AIDS Conference moved from Boston to Amsterdam, and the US has not hosted an International AIDS Conference since then.
Although President Clinton promised to end to the ban by executive order during his 1992 election campaign, he ultimately enshrined the policy in the law when he signed the 1993 NIH Reauthorization Act – which included an amendment that permanently added HIV to the PHS list.
Since then, US HIV/AIDS immigration policy has been widely condemned by civil society groups, which argue that it discourages HIV testing and treatment of migrants who may be in the US illegally. At a round table discussion held last month by the Global Health Council, GMHC’s Nancy Ordover said that the US policy is a "violation to human rights and a threat to public health in the United States and abroad."
Several UK studies have highlighted the adverse effects of this policy on even short-term visitors’ anti-HIV drug adherence and mental health. Results from a 2004 Brighton study, as well as 2005 studies from London and Manchester have found that travelling to the US was often a “negative practical and emotional experience”.
Reactions to the White House statement have been muted. Dr Donald Abrams, one of the organisers of Sixth International AIDS Conference told the San Francisco Chronicle that it was "a step that will serve to bring us in line with the rest of the civilised world,'' but wasn't sure if it was enough to persuade International AIDS Conference organisers to hold future conferences on US soil.
"It's a step away from a terribly discriminatory and inappropriate policy, but it doesn't go far enough,'' added Leonard Rubenstein, executive director of Physicians for Human Rights. "This is a treatable disease. If you want to remove stigma from AIDS, you have to go the whole distance, and eliminate all restrictions on entry to the United States for people with HIV.''
However, a spokesperson for Democratic Congresswoman Barbara Lee – who co-authored the bills that created PEPFAR and the Global Fund – told the Global Health Council meeting last month that she plans to introduce legislation during the 110th Congress that would totally overturn the ban for both immigrants and short-term visitors.