Health officials applaud end to 22-year U.S. policy for travelers, immigrants

[JillA 2]

http://www.msnbc.msn.com/id/31910664/ns/health-aids/

Foreigners who have HIV would be allowed to travel and immigrate to the United States under a plan by federal health officials to lift a 22-year ban on infected visitors that critics say was unnecessary from the start.

Officials at the Centers for Disease Control and Prevention are seeking public comment through Aug. 17 on the proposal, which would remove HIV from the list of diseases that can bar entry to the country and do away with HIV testing as part of medical exams for permanent residence and, in some cases, travel visas.

“We’re trying to end the stigma and the discriminatory practice for a disease that doesn’t warrant exclusion for coming into this country,” said Dr. Martin Cetron, director of the CDC’s Division of Global Migration and Quarantine. “We have to appreciate this is not a threat we face from abroad.”

Infectious disease experts and AIDS advocates already are cheering the plan to remove the HIV ban, which was enacted at a time when people — and politicians — wrongly feared that the disease could be spread through casual contact, said Dr. Michael Saag, incoming chairman of the HIV Medicine Association.

“There is no scientific or public health rationale for excluding people with HIV infection from the U.S.,” said Saag, who also heads the division of infectious diseases at the University of Alabama at Birmingham. “Frankly, it was a bit of an embarrassment, even then.”

But immigration critics say they’re leery of the proposal that could allow an average of 4,275 HIV-infected people into the country annually, with a lifetime medical cost of about $94 million for those admitted during the first year, according to CDC estimates published this month in the Federal Register.

“It becomes a matter of collective responsibility because of the cost,” said Ira Mehlman, a spokesman for the Federation for American Immigration Reform, a nonprofit group based in Washington, D.C. “The American people shouldn’t be in a position where they have to pay for it.”

Others are concerned that HIV-positive visitors and immigrants will spread the disease.

About 1 million immigrants move to the U.S. each year, and about 6.6 million people visit using nonimmigrant visas, according to State Department statistics. The new rule would authorize entrance for those formerly barred solely because they have HIV, and it would eliminate the disease from the routine medical exams now required for immigration and for certain travelers.

OK the funniest part of the article is this guy's quote:

“It seems rather odd to let people in with a health problem like that,” said John Vinson, president of the American Immigration Control Foundation based in Monterey, Va. “With HIV and the way it’s spread, people have desires and they’ll act on those desires and spread it to other people. Why bring on a problem on yourself when you don’t have to?”

"People have desires and they'll act on those desires and spread it to other people"

[nurse1967 287]

I am sorry I think people with HIV should be excluded.

[JillA 2]

I am sorry I think people with HIV should be excluded.

Well speaking soley about family based immigrants, if you are moving here to be with your husband or wife, you (hopefully)! only having intimate relations with 1 person. So if you are very careful and your spouse is supportive, I don't see why there would be a fear of them spreading HIV. They are moving to the US to be with their spouse not sleep around

[Krikit 1,164]

Wow. Has it been that long already? I'm so glad they're proposing this. But I don't know if it will pass. After all the craziness I've seen since I moved here, it won't surprise me in the least if it gets shot down.

[nurse1967 287]

Well I am an ICU nurse and have seen many cases of HIV. There are also many cases where patients find out they have HIV and don't inform their S/O. Really makes me disgusted.

[reeses16 8]

I think the test should remain a required part of the medical, but it should not be a reason for denial. But then again, I wish the US would making HIV testing mandatory or routine where you have to opt-out if you do not want the test. I realize the person having the medical may not disclose their results, but they couldn't claim they didn't now their status.

[Hugglebuggles 60]

I've never really questioned the HIV policy. If you have a disease that can be spread to others and put those people in immediate danger then why shouldn't that be grounds for inadmissability? It is true that if you are married or engaged to a US citizen, you should only intend on sleeping with that one person, but there are other ways to spread the disese other than sex. And visitors visas? They could come, party it up and end up unintentionally infecting other people. Its unfortunate these people have devestating infections, and unfortunate they face discrimination because of it, but you are opening your doors to an influx of potentially dangerous people. What happens after the ban is lifted? Will you have a huge amount of individuals that were previously denied visas based on their infection that will now apply for waivers and be granted legal access to the country?

I'm not saying i'm 100% against it, but I am rather skeptical. I think some things need to be considered before enacting this huge change in policy.

[CBR 0]

When you think about all the different types of visas available, the issue of not admitting people that are HIV positive is quite complex. It makes no sense for family based visas to me because you are in a committed relationship (fiance/spouse visas). It's a good idea to test because it's something the partner needs to know and the couple needs to make decisions about together. But the decision to continue with the visa process should be up to the couple/family involved, not the government. IF it's a parent, child etc... and they're not admitted due to HIV, it's ridiculous. What if the entire family is coming and poor grandma who had a blood transfusion during surgery isn't admitted due to her HIV status? Also, what about all the people adopting children from other countries that are HIV positive? How is that happening under this rule? I have read many articles about this.

[reeses16 8]

Hugglebuggles, I understand your reasoning. But have you considered other disease that can be spread to others and put people in danger? There is TB, Hepatitis A, B, C, to name a few. But for these diseases all that is required is that the person is undergoing treatment.

I wouldn't be concerned about a flood of HIV positive people immigrating to the US. For certain visa categories there are quotas that cannot be exceeded. And there shouldn't be a great concern about tax dollars being spent on HIV+ immigrants since they would have US sponsors (I-864). I don't know in terms of cost comparison, but we allow immigrants who are obese and who smoke knowing that these factors/behaviors led to a greater burden of disease and higher medical costs.

I also doubt changing the law will make the US a hot spot for sexual tourism. But in places known for sexual tourism, such as Thailand, their HIV/AIDS epidemic had been projected to rival that of Sub-Saharan Africa. But because of early action and HIV policies, Thailand has prevented this.

Yes, there are others ways to spread HIV besides sex. But medical professionals take universal precautions, meaning they assume that every patient they work with has disease transmittable by blood (such as HIV). Blood donations are screened. So what other routes of transmission really effect anyone besides the HIV+ person's sexual partner.

CBR, thats a good question. I'm sure there is a waiver that can be obtained for adoptions. I wonder if HIV+ children get their waivers approved more often. I think people can't blame children for contracting HIV, but an adult is usually thought of having been irresponsible in order to contract HIV. But if people really want to play it a hard line, then children should be excluded as well since they grow up to sexually active adults who will put others at risk.

This is an incredibly complex issue! I enjoyed reading everyone's thoughts.