Undermining Public Health and Human Rights: The United States' HIV Immigration and Travel Ban <ul><li>Jirair Ratevosian, M...
Common Immigration Options– Non-Immigrant Visas <ul><li>Common visas </li></ul><ul><ul><li>“ Tourist” visa </li></ul></ul>...
Common Immigration Options – Immigrant Visas <ul><li>Labor Certification </li></ul><ul><li>Diversity Visa Lottery </li></u...
Ban on immigration and travel <ul><li>America!  Banning HIV+ immigrants since 1987 </li></ul><ul><li>Law versus policy </l...
Inadmissibility <ul><li>Classes of inadmissible immigrants </li></ul><ul><ul><li>Serious criminals; aggravated felons etc....
HIV and Non-Immigrant Visas <ul><li>No HIV test </li></ul><ul><li>“ Communicable Disease of Public Health Significance” Qu...
“ 2008 Streamlining?” <ul><li>In October, DHS issued new regulations for 30 day waivers </li></ul><ul><li>Consular officer...
HIV and Legal Permanent Residence  <ul><li>Must undergo medical exam </li></ul><ul><li>Must qualify for waiver </li></ul><...
You qualify for a waiver if you are: <ul><li>The spouse or unmarried son or daughter of a USC or LPR </li></ul><ul><li>The...
Other HIV Waiver Requirements <ul><li>Form I-601 (and fee $545) </li></ul><ul><li>Demonstrate the danger to public health ...
Insurance strategy for family cases <ul><li>File adjustment application w/ EAD application </li></ul><ul><li>“ Window peri...
Other insurance possibilities? <ul><li>Blue Cross Blue Shield </li></ul><ul><li>Travel insurance </li></ul><ul><li>Clinica...
HIV and Naturalization <ul><li>No HIV ground to deny naturalization application </li></ul><ul><li>No public charge issues ...
Permanently Residing Under Color of Law (“PRUCOL”) <ul><li>Not defined in U.S. immigration law </li></ul><ul><li>Definitio...
Travel Restrictions in the Global Context  Slide borrowed from David Hans-U. Haerry,  European AIDS Treatment Group
Categories of Restrictions <ul><li>Countries without restrictions  </li></ul><ul><li>Countries with entry bar </li></ul><u...
Global Context: HIV related travel & residence regulations   Slide borrowed from David Hans-U. Haerry,  European AIDS Trea...
Name & Shame (2008) <ul><li>Countries with restrictions  </li></ul><ul><li>Andorra, Armenia, Belarus, Bulgaria, Cyprus, Ge...
Deportation - 30 countries <ul><li>Bangladesh:  likely if authorities know serostatus.   </li></ul><ul><li>Hungary:  possi...
How are restrictions justified?   <ul><li>People with HIV  </li></ul><ul><li>a danger to public health </li></ul><ul><li>s...
25 years in the epidemic, we know: <ul><li>HIV is not highly contagious, transmissions are due to specific behaviours (tar...
Statements on public health issue <ul><li>1987 WHO expert consultation:  “ no screening programme of international travell...
2008 International Task Team on HIV-related Travel Restrictions: <ul><li>“ There is  no public health rationale  for restr...
Recommendation: Drop restrictions based on  public health  concerns <ul><li>Although infectious, HIV cannot be transmitted...
Global Effort to overcome restrictions <ul><li>Overcome perception that these protect public health </li></ul><ul><li>Over...
Students and Health professionals helped reauthorize PEPFAR <ul><li>Student chapters mobilized Deans and faculty to submit...
Students kept AIDS in the media
What can students and health professionals do? <ul><li>Raise awareness </li></ul><ul><li>Reach out to media to cover the i...
Write a Letter to the Editor <ul><ul><li>Keep it short and sweet  </li></ul></ul><ul><ul><li>Pick one or two points that m...
Database  www.hivtravel.org
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Undermining Public Health And Human Rights The United States Hiv Immigration And Travel Ban

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  • Undermining Public Health And Human Rights The United States Hiv Immigration And Travel Ban

    1. 1. Undermining Public Health and Human Rights: The United States' HIV Immigration and Travel Ban <ul><li>Jirair Ratevosian, MPH </li></ul><ul><ul><li>US Field Coordinator, Health Action AIDS Campaign </li></ul></ul><ul><ul><li>Physicians for Human Rights </li></ul></ul><ul><li>Aaron C. Morris </li></ul><ul><ul><li>Staff Attorney </li></ul></ul><ul><ul><li>Immigration Equality </li></ul></ul>
    2. 2. Common Immigration Options– Non-Immigrant Visas <ul><li>Common visas </li></ul><ul><ul><li>“ Tourist” visa </li></ul></ul><ul><ul><li>Visa Waiver Program </li></ul></ul><ul><ul><li>Student Visa </li></ul></ul><ul><ul><li>Work Visa </li></ul></ul><ul><li>Visas versus admittance </li></ul>
    3. 3. Common Immigration Options – Immigrant Visas <ul><li>Labor Certification </li></ul><ul><li>Diversity Visa Lottery </li></ul><ul><li>Humanitarian Adjustment (asylum, CRAA, VAWA…) </li></ul><ul><li>Family Unification </li></ul><ul><ul><li>Marriage (opposite-sex only please) </li></ul></ul><ul><ul><li>Parents or children </li></ul></ul><ul><ul><li>Siblings </li></ul></ul>
    4. 4. Ban on immigration and travel <ul><li>America! Banning HIV+ immigrants since 1987 </li></ul><ul><li>Law versus policy </li></ul><ul><ul><li>President Clinton’s proposed exec order </li></ul></ul><ul><ul><li>Congress passes explicit ban in 1993 </li></ul></ul><ul><li>Proposed regs stalled in OMB since December </li></ul>
    5. 5. Inadmissibility <ul><li>Classes of inadmissible immigrants </li></ul><ul><ul><li>Serious criminals; aggravated felons etc. </li></ul></ul><ul><ul><li>Terra-ists and </li></ul></ul><ul><ul><li>People living with HIV </li></ul></ul><ul><li>Congress repeals ban in July 2008 </li></ul><ul><ul><li>DHS – streamlines regs </li></ul></ul><ul><ul><li>HHS – edits list of diseases </li></ul></ul>
    6. 6. HIV and Non-Immigrant Visas <ul><li>No HIV test </li></ul><ul><li>“ Communicable Disease of Public Health Significance” Question Asked </li></ul><ul><li>30 Day Waivers </li></ul><ul><ul><li>“ Humanitarian” reasons such as: attend conferences; receive medical treatment; visit close relatives, conduct business </li></ul></ul><ul><li>Designated Event Waivers </li></ul>
    7. 7. “ 2008 Streamlining?” <ul><li>In October, DHS issued new regulations for 30 day waivers </li></ul><ul><li>Consular officer’s “quick” decision if: </li></ul><ul><ul><li>Medication </li></ul></ul><ul><ul><li>Private health insurance </li></ul></ul><ul><ul><li>No green cards </li></ul></ul><ul><li>Redundant, redundant, redundant </li></ul><ul><ul><li>No immigrant intent </li></ul></ul><ul><ul><li>No public charge </li></ul></ul>
    8. 8. HIV and Legal Permanent Residence <ul><li>Must undergo medical exam </li></ul><ul><li>Must qualify for waiver </li></ul><ul><ul><li>Either with qualifying relative or </li></ul></ul><ul><ul><li>As asylee/refugee </li></ul></ul><ul><li>Absent a qualifying relative, no green card </li></ul><ul><ul><li>For employment based applications </li></ul></ul><ul><ul><li>For diversity visa lottery winners </li></ul></ul>
    9. 9. You qualify for a waiver if you are: <ul><li>The spouse or unmarried son or daughter of a USC or LPR </li></ul><ul><li>The minor unmarried lawfully adopted child of a USC </li></ul><ul><li>The parent of a son or daughter who is a USC or LPR </li></ul><ul><li>Self-petitioning VAWA spouse or child </li></ul><ul><li>Missing relatives: </li></ul><ul><ul><li>Married son or daughter of USC </li></ul></ul><ul><ul><li>Sibling of USC </li></ul></ul>
    10. 10. Other HIV Waiver Requirements <ul><li>Form I-601 (and fee $545) </li></ul><ul><li>Demonstrate the danger to public health of U.S. is minimal </li></ul><ul><li>Demonstrate that possibility of spread of infection is minimal </li></ul><ul><li>Demonstrate no cost incurred by any agency of U.S. government without prior consent of agency = private insurance </li></ul><ul><ul><li>Special problems for consular processing </li></ul></ul><ul><li>Public charge separate but related issue </li></ul>
    11. 11. Insurance strategy for family cases <ul><li>File adjustment application w/ EAD application </li></ul><ul><li>“ Window period” during which applicant can work </li></ul><ul><ul><li>Get job w/ insurance or </li></ul></ul><ul><ul><li>Add to family member’s insurance </li></ul></ul><ul><li>ADAP as supplement (not enough on its own) to cover pre-existing condition </li></ul>
    12. 12. Other insurance possibilities? <ul><li>Blue Cross Blue Shield </li></ul><ul><li>Travel insurance </li></ul><ul><li>Clinical trial program </li></ul><ul><li>Government is already paying for healthcare </li></ul>
    13. 13. HIV and Naturalization <ul><li>No HIV ground to deny naturalization application </li></ul><ul><li>No public charge issues for naturalization </li></ul><ul><ul><li>Possible to have fee waived for naturalization application (except for finger prints) </li></ul></ul><ul><li>Possible HIV-related waiver of English/civics requirement </li></ul>
    14. 14. Permanently Residing Under Color of Law (“PRUCOL”) <ul><li>Not defined in U.S. immigration law </li></ul><ul><li>Definition used in benefits law – “known to DHS, DHS is not taking steps to deport him/her” </li></ul><ul><li>Examples: </li></ul><ul><ul><li>Extended voluntary departure (eliminated after 1996) </li></ul></ul><ul><ul><li>Deferred action </li></ul></ul><ul><ul><li>Some pending applications </li></ul></ul><ul><ul><ul><li>But receipt of benefits may be a problem for some applications </li></ul></ul></ul><ul><ul><ul><li>Not Temporary Protected Status </li></ul></ul></ul>
    15. 15. Travel Restrictions in the Global Context Slide borrowed from David Hans-U. Haerry, European AIDS Treatment Group
    16. 16. Categories of Restrictions <ul><li>Countries without restrictions  </li></ul><ul><li>Countries with entry bar </li></ul><ul><li>Countries with short term restrictions </li></ul><ul><ul><li>For stays less than 90 days, require disclosure of HIV status for short term stays OR demand mandatory HIV testing for short term stays  </li></ul></ul><ul><li>Countries with long term restrictions  </li></ul><ul><ul><li>for stays longer than 90 days, required disclosure of status and HIV testing when applying for such a permit </li></ul></ul><ul><li>Countries with contradictory information  </li></ul><ul><ul><li>Information received from various sources is either contradictory, not conclusive, or it relates only to particular groups or regions in the country </li></ul></ul><ul><li>Countries without information  </li></ul>
    17. 17. Global Context: HIV related travel & residence regulations Slide borrowed from David Hans-U. Haerry, European AIDS Treatment Group <ul><li>14 States deny entry or require status disclosure even for short term stays </li></ul><ul><li>30 countries deport HIV+ foreigners </li></ul>
    18. 18. Name & Shame (2008) <ul><li>Countries with restrictions </li></ul><ul><li>Andorra, Armenia, Belarus, Bulgaria, Cyprus, Georgia, Germany, Greece, Hungary, Israel, Kazakhstan, Lithuania, Moldova, Poland, Romania, Russia, Slovakia, Tajikistan, Turkey, Turkmenistan, Ukraine, Uzbekistan, USA </li></ul><ul><li>8 countries bar entry for any reason/length of stay </li></ul><ul><li>Brunei, China, Oman, Qatar, South Korea, Sudan, UAE, Yemen. </li></ul><ul><li>5 countries deny ST visa (10-90 days) </li></ul><ul><li>Egypt, Iraq, Singapore, Tunisia, Turks & Caicos Islands </li></ul>
    19. 19. Deportation - 30 countries <ul><li>Bangladesh: likely if authorities know serostatus. </li></ul><ul><li>Hungary: possible if advised by authorities. </li></ul><ul><li>Jordan: recorded cases of Africans. </li></ul><ul><li>Korea (North): reason no treatment. </li></ul><ul><li>Kuwait: immediate; no entry with HIV. </li></ul><ul><li>Malaysia: possible by law, applies to migrant workers. </li></ul><ul><li>Qatar: immediate; incl tourists. </li></ul><ul><li>Russia: recorded by NGOs, people with HIV have 3 months to leave. </li></ul>
    20. 20. How are restrictions justified? <ul><li>People with HIV </li></ul><ul><li>a danger to public health </li></ul><ul><li>spread the disease </li></ul><ul><li>a burden for society & health care budgets (medical migration, poor health care system) </li></ul><ul><li>short life expectancy, not contributing to society </li></ul><ul><li>HIV comes from outside & we can stop it at border </li></ul><ul><li>Does this reflect reality in 2008? </li></ul>
    21. 21. 25 years in the epidemic, we know: <ul><li>HIV is not highly contagious, transmissions are due to specific behaviours (target for intervention) </li></ul><ul><li>Safer sex and safer use are everybody’s responsibility </li></ul><ul><li>Screening at borders: wrong message, undermining public health efforts on HIV prevention & care. </li></ul><ul><li>People facing restrictive measures will hide status, avoid HIV testing & care services. </li></ul>
    22. 22. Statements on public health issue <ul><li>1987 WHO expert consultation: “ no screening programme of international travellers can prevent the introduction and spread of HIV infection”. </li></ul><ul><li>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”. </li></ul>
    23. 23. 2008 International Task Team on HIV-related Travel Restrictions: <ul><li>“ 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 </li></ul>
    24. 24. Recommendation: Drop restrictions based on public health concerns <ul><li>Although infectious, HIV cannot be transmitted by the mere presence of a positive person or by casual contact </li></ul><ul><li>Transmitted through specific behaviors which others can protect against </li></ul><ul><li>Restrictive measures may actually undermine prevention and therefore public health efforts </li></ul>
    25. 25. Global Effort to overcome restrictions <ul><li>Overcome perception that these protect public health </li></ul><ul><li>Overcome ignorance, stigma and discrimination that informs restrictions </li></ul><ul><li>Ensure equal access to mobility </li></ul><ul><li>Ensure entry, stay, residence regulations treat HIV same as comparable health conditions </li></ul><ul><li>Support dialogue and joint action by health officials and immigration/justice officials </li></ul><ul><li>Expand HIV prevention, treatment, care and support in sending and receiving countries </li></ul>
    26. 26. Students and Health professionals helped reauthorize PEPFAR <ul><li>Student chapters mobilized Deans and faculty to submit comments during December 2007 public commenting period </li></ul><ul><li>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 </li></ul>
    27. 27. Students kept AIDS in the media
    28. 28. What can students and health professionals do? <ul><li>Raise awareness </li></ul><ul><li>Reach out to media to cover the issue </li></ul><ul><li>Speak out during Public Commenting Period for HSS (stay tuned!) </li></ul>
    29. 29. Write a Letter to the Editor <ul><ul><li>Keep it short and sweet </li></ul></ul><ul><ul><li>Pick one or two points that most resonate with you and expand </li></ul></ul><ul><ul><li>Include the title of the article </li></ul></ul><ul><ul><ul><li>Ex. In response to “Obama Repeals Travel Ban”(1/19), the article fails to mention other steps needed to address the feminization of AIDS. </li></ul></ul></ul><ul><ul><li>Include your contact information </li></ul></ul><ul><ul><li>Identify yourself as a member of PHR Student Chapter </li></ul></ul><ul><ul><li>Email the letter to the Letters Editor </li></ul></ul><ul><ul><ul><li>Call/email to follow-up </li></ul></ul></ul>
    30. 30. Database www.hivtravel.org

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