In-depth: Crime and punishment: Criminalisation and HIV

GLOBAL: Planes, trains and travel bans

Photo: F18E777/Flickr

Leaving on a jet plane

Johannesburg, 28 November 2008 (PlusNews) - In 2002, illicit arms dealer Aleksic Jovan flew more than 200 tons of weapons in war-torn Liberia, contributing to a conflict estimated to have killed about 250,000 people. Years ago, Linda Kisuna’s husband contracted a sexually transmitted disease. What do they have in common? Both Jovan and Kisuna's husband have been denied entry to countries across the world.

About 70 countries have HIV-related travel restrictions on their books, according to the Global Database on HIV-related travel restrictions, but the information is so hard to find and often contradictory that no one, including UNAIDS, knows for sure.

About 10 countries, including China, Armenia, Sudan and the United States, technically restrict HIV-positive persons from entering the country, regardless of length of stay, despite recent efforts in the US to repeal its more than 20-year-old ban on HIV-positive visitors.

Although the Senate repealed the law in July, when it extended the President's Emergency Plan for AIDS Relief (PEPFAR) and US President George W. Bush signed the bill into law, the ban remains in effect until the US Department of Health and Human Services (HHS) removes HIV from its list of communicable diseases.

Rachel Tiven, executive director of Immigration Equality (IE), a lobby group, said she hoped the HHS would soon revise its communicable diseases list, yet disagreed with recent changes to the waivers that have allowed some HIV-positive travellers to get around the ban.

"We are disappointed that the Bush administration has issued the 'streamlined' travel [requirements], which in fact were not streamlined at all, when the repeal of the entire [HIV] ban is imminent," she said.

In late September the Department of Homeland Security, which is responsible for immigration, released changes to travel waivers for HIV-positive visitors that, the IE said, imposed stricter criteria rather than streamlining the process.

For instance, travellers must prove they have private medical aid accepted in the US, and even those with close relatives in the country are prohibited from applying for a temporary green card while in the country. The lobby group maintains that HIV is the only medical condition subject to these regulations.

According to Cambodian AIDS activist Vanna Rainsey,* these conditions were already tough enough. When Rainsey was invited to attend the UN General Assembly Special Session (UNGASS) on HIV/AIDS, major international aid organisations sent her letters of invitation stating both her HIV-positive status and her reason for being in the US, in compliance with immigration regulations. However, when she arrived in New York, immigration officials used her status as a reason to cancel her American visa.

Reading between the lines

Escape from Guantanamo Bay

The Guantanamo Bay Detention camp, colloquially known in the US as "Gitmo", has made headlines for its role in recent US military history, but before the twin towers fell it made headlines for different reasons.

In September 1991, Jean-Bertrand Aristide, Haiti's first democratically elected president in 200 years, was ousted from power in a coup. In the wake of the violence that followed, some Haitians continued what had been a steady wave of migration dating back to the days of dictator François "Papa Doc" Duvalier.

In the early 1990s, Guantanamo Bay was used to house illegal Haitian migrants picked up in crowded wooden boats en route to the US by the US Coast Guard. At one point, the camp held about 200 HIV-positive migrants. Advocates said all of them would have had grounds for political asylum, were it not for their HIV status.

They spent about 18 months on the island before a federal judge ordered their release and closure of the camp, writing in his judgment that "Although the defendants euphemistically refer to its Guantanamo operation as a 'humanitarian camp' the facts disclose that it is nothing more than an HIV prison camp presenting potential public health risks to the Haitians held there."

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Governments usually cite two rationales for imposing restrictions: they will help control the spread of HIV, and save host countries the cost of HIV-related treatment.

Neither reason was very convincing, said Susan Blair Timberlake, Senior Law and Human Rights Adviser to UNAIDS. "To prevent people entering a country to prevent the spread of HIV into the country ... [doesn't] make sense now, in the age where there is a national epidemic in every country. If that's your strategy, then you should close the borders against the many nationals that leave and then return."

When the Cuban government began treating its first HIV-positive patients in 1986, it instituted a mandatory quarantine policy that sent people living with the virus to state sanatoriums, but the legislation was repealed in 1993.

"Beneath [these laws] there is an assumption that HIV-positive people will act irresponsibly - something that isn't supported by evidence, and that's problematic," said Timberlake. If treatment costs were a concern, then countries should screen those wishing to permanently settle in the country individually, she commented.

Immigration officers are seldom concerned with human rights, such as the right to seek asylum, confidential testing, and the right to protect the family unit. In response, UNAIDS recently formed an international task team to raise awareness about travel bans and human rights abuses.

Leavin’ on a jet plane

Linda Kisuna* has been trying to bring her HIV-positive husband from Kenya to live with her and their daughter in the US for about a year. "[The authorities need] an HIV waiver [and] insurance, which they know is impossible to get," she told IRIN/PlusNews. "No insurance [company] is willing to insure somebody who is outside this country [the US], and those that do won't insure a pre-existing condition [like HIV]."

According to the US government, the insurance requirement is a reasonable condition to prevent any financial burden being shifted from the visitor to the taxpayer in case of a medical emergency.

"It's humiliating when you have to travel to your country to see your loved one, who has been banned from coming to join you due to his status despite your willingness to support him," she said. "Every year I have to travel home because I don't want to break those bonds, so I work overtime; I work so hard to raise the money for the tickets."

Lawyers have told Kisuna there is not much they can do to get around the insurance clause, so she is trying to find a clinic or an organisation that will sign an affidavit saying they will be responsible for her husband's care.

If this works, Kisuna, who is in the US on a temporary residence visa, will apply for citizenship; if not, her dream of reuniting her family may be dashed. "I'm trying my last chance, this time around, to get him here. But if it doesn't work then I'll have to think otherwise; we can't live like this."

*not their real names

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Crime and punishment: Criminalisation and HIV
December 2008

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