Lifting Of HIV Ban Leaves Many Immigrants In Limbo

For decades, people infected with HIV have not been allowed to immigrate or become permanent U.S. residents. Congress has removed the statute, and the Department of Health and Human Services is working on a more lenient immigration rule. But many people with HIV are worried their applications and visas may expire before that happens.

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And as she mentioned, AIDS prevention is a key goal of these clean needle efforts. But people who are HIV positive have long been barred from becoming residents of the United States. That ban, though, could soon be gone. The Department of Health and Human Services is working on a new more lenient immigration rule.

Still, as NPR's Brenda Wilson reports, many non-citizens with HIV who are currently in this country are worried that their own applications and work visas may expire before the law changes.

BRENDA WILSON: Trying to control disease by controlling who comes in and out of a country is as old as the Middle Ages and not so ancient U.S. history of immigration. That's according to Zita Lazzarini, a bioethicist at the University of Connecticut.

Professor ZITA LAZZARINI (Health Law and Bioethics, University of Connecticut School of Medicine): Most of our relatives - certainly my Italian relatives who came over in the early 1900s - all got checked for contagious diseases to the degree that they could check people at the time, and they could be turned back.

WILSON: In 1952, Congress gave federal health officials the discretion to decide which diseases were grounds for excluding people who wished to immigrate to the U.S. But it was Republican Senator Jesse Helms who singled out HIV, first, by demanding that President Reagan issue an executive order in 1987 and then by getting Congress to enact it into law in 1993.

Lazzarini says that from the beginning of this political battle, it was well understood that there was no public health justification for the rule.

Prof. LAZZARINI: We have known for many more years that HIV is not transmitted casually, that there is more HIV in the country and probably more HIV positive people leaving the country than coming in.

WILSON: And there it stood until 2008, when Congress again voted to allow federal health officials to determine which diseases belonged on the exclusionary list. During the debate, sponsors noted that the ban put the U.S. in strange company with countries like:

Prof. LAZZARINI: Armenia, Brunei, Iraq, Libya, Moldova, Oman...

WILSON: But while the Department of Health and Human Services finishes implementing the rule that actually lifts the ban, many immigrants have been left in limbo, like this young man from Brazil. He's here legally under an employer's sponsorship, but he's afraid he'll lose if he goes public with any particulars about himself.

Unidentified Man #1: It's because my job. If I tell them about my status, I'm still not 100 percent safe.

WILSON: He came for a visit not quite six years ago with a friend who helped him get the job, and then he met the man who became his partner.

Unidentified Man #1: We went together to do the test and I finally got the results and I was like, oh, nice. Depress and...

Unidentified Man #2: I mean, it literally took six...

Unidentified Man #1: ...cry and, yeah, and...

Unidentified Man #2: To the initial shock that you have to go through, right? And then it's the aftermath of just dealing with that stress.

WILSON: The work visa he discovered was no protection against being sent home, so the couple hired Jim Alexander(ph), an attorney who has several HIV positive clients seeking residency in the U.S.

Mr. JIM ALEXANDER (Attorney): And for some individuals, it may be possible. One, if they have a relative who can be their sponsor for a waiver essentially, or if their return to their home country would cause them to fear persecution on account of their HIV status.

WILSON: There are still opponents to allowing people with HIV into the U.S. Bob Goldsborough of the American Immigration Control Foundation fears they will contribute to the spread of the disease and increase health care cost.

Mr. ROBERT GOLDSBOROUGH (President, American Immigration Control Foundation): We have to differentiate what is good for this country and what is harmful to this country. And to treat an HIV person on welfare that can't afford it, the cost are well over $10,000 per person per year. And we don't need to increase this problem, this threat.

WILSON: The federal government estimates that in the past year, a little over 400 visa applicants were denied U.S. residency because of HIV and other diseases.

Alexander says even with the waiver, an immigrant has to show that they are able to work, for example, or have a sponsor and some means of support.

Mr. ALEXANDER: And so, for an individual who is HIV positive or any individual, whether they seem to be healthy or not at the time that they're applying has that burden. And they would have to present evidence that they are not going to rely upon government resources for their health care.

WILSON: It's only recently that U.S. courts allowed gays and lesbians to immigrate to the U.S. But unlike straight married couples, gay citizens can't sponsor partners from abroad. So that means the Brazilian's partner cannot help him immigrate, though the partner is able to carry him on his health insurance.

Unidentified Man #1: When I found out about my situation, it was like at the beginning of our relation. And most people, they would just - oh, whatever. You're HIV positive. You go. And he, otherwise, he just help me more than my family because I cannot talk with them. It's a different love, what I feel for him, but it is truly.

WILSON: In every sense of the word, a partnership. Perhaps, it's the evening light coming into the darkened apartment, but you might get the impression that these two people have shut themselves away from the world. That wouldn't be true. But they fear that telling others about his HIV status might jeopardize relationships with friends and co-workers, and possibly separate them if the ban isn't lifted soon.

Brenda Wilson, NPR News.

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