HIV-related travel restrictions on entry, stay and residence
People living with HIV face stigma and discrimination on a daily basis, but no form is as disgraceful and, in some cases, inhumane as the indignity they suffer when trying to enter or stay in a country with HIV-related travel restrictions. This article briefly explores the subject of HIV-related travel restrictions with a real life example.
Harjeet, an Indian citizen, worked in Dubai, United Arab Emirates, for five years as a chauffeur. When his contract expired, he returned to India. After a while he decided to find work in Saudi Arabia where medical tests were a visa requirement. The doctor who tested him was a bit troubled by his blood test result but said that he could fix the result for a fee which Harjeet subsequently paid. Then Harjeet borrowed money from friends and family to fly to Saudi Arabia.
After his arrival it took him 20 days to find a “sponsor” who would help him convert his tourist visa into a working visa. The process again required medical tests, including a blood test. When the result of the blood test came back, Harjeet lost his sponsor and was detained in a prison cell. He appeared in court the next day where the judge ordered a second blood test to be done. The test result was the same as the first. Harjeet did not know what was happening until the administrator of the test told him that he was infected with the human immunodeficiency virus (HIV). They deported him soon after that.
Back in India, he slipped into a depression and became severely ill. His symptoms worsened when his family found out that he was HIV-positive and left him abandoned in a hospital. The staff of the HIV care centre where he lived nursed him back to health (UNAIDS, 2009).
Harjeet’s experience is not an isolated case. The Joint United Nations Programme on HIV/AIDS (UNAIDS) document, from which extracts of Harjeet’s experience was taken, contains a mere fraction of the accounts of disgrace, discrimination and loss of livelihood that people living with HIV/AIDS (PLWHA) have to face when they travel to countries with HIV-related restrictions on entry, stay and residence (UNAIDS, 2009).
These HIV-related restrictions on entry, stay and residence came into being during the 1980s when governments did their best to protect their citizens from the new disease. They passed these restrictions into law even though the World Health Organization (WHO) recommended that they not do so since it would not be beneficial to everyone involved (Wiessner & Lemmen, 2013). As a result, these restrictions fed the stigma PLWHA endured on a daily basis (UNAIDS, 2013).
The effect of restrictions to the USA
Before 2010 the United States of America (USA) was one such country. Under the Visa Waiver Program citizens of 27 countries could enter the USA without a visa for up to 90 days. However, HIV-infected travellers could not. Their passports were stamped showing that they were barred from entry. However, there was a way for PLWHA from these and other countries to enter the USA. This entailed obtaining a visa and a waiver of ineligibility, which were only granted under special circumstances (Mahto et al., 2006).
Mahto et al. (2006) reported that 85% of United Kingdom (UK)-based travellers to the USA entered the country illegally. Some even interrupted their treatment for the duration of their visit to escape detection by custom officials at airports.
Countries with travel restrictions
In 2010, the USA and China lifted their bans on entry (Wiessner & Lemmen, 2013). Countries that subsequently lifted their bans on entry, stay or residence since 2010 are: Armenia, Bulgaria, Namibia, Ukraine and Moldova. Some reports (UNAIDS, 2013) state that South Korea lifted their ban, but uncertainty remains (Wiessner & Lemmen, 2013). Table 1 below lists some countries with their various restrictions.
Table 1: Countries with HIV-related travel restrictions (Wiessner & Lemmen, 2013).
| Countries which force HIV-positive foreigners to leave
||Countries that categorically refuse entry
||Countries with restrictions for short-term stays
||Papua New Guinea
|United Arab Emirates
Of the approximately 200 countries in the world, 66 have some form of HIV-related travel restriction. Of these, 29 were willing to deport PLWHA. HIV tests are mandatory in most of the 66 countries (Wiessner & Lemmen, 2013; Ford, 2013).
Fortunately, PLWHA do not encounter many problems for short-term (1-3 months) tourist visits when traveling to such countries. Their HIV-positive status does become a problem when they wish to study or work in those countries, which usually requires stays longer than three months (Wiessner & Lemmen, 2013).
The rationale and consequences behind the HIV-retrictions
According to Rushton (2012) and Amon and Todrys (2008), the reasons countries with HIV-related travel restrictions offer are
- PLWHA are a threat to public health
- PLWHA drain the country economically
These reasons are given despite the fact that PLWHA, especially migrant workers who bear the brunt of discrimination (Chang, 2013), make substantial contributions to the countries’ economies and cannot exercise their human right of the freedom to move (Amon & Todrys, 2008).
Amon and Todrys (2008) also state that these restrictions instead of protecting public health pose a greater danger since it fosters stigma and discrimination. They provide a false sense of security where the public strongly associates HIV with foreigners and reckless behaviour. It also becomes difficult to discuss and obtain HIV prevention and treatment measures in public.
To complicate matters, some sub-Saharan African countries have recently passed laws that negatively affect men who have sex with men and women who have sex with women in the response to HIV and AIDS. These laws foster discrimination and hold implications for PLWHA from this key population in these countries (Raghavan, 2014).
What we presented here is only a summary of the issue of HIV-related travel restrictions. As the debate rages between governments, the International AIDS Society, Deutsche AIDS-Hilfe, International Task Team on HIV-related Travel Restrictions and many other organisations, you are encouraged to visit the Global Database on HIV-related Travel Restrictions (Global Database, 2013). There you can obtain a report (Wiessner & Lemmen, 2013) which gives specific information on the HIV-related travel restrictions of almost every country in the world including those in sub-Saharan Africa.
- Amon, J. J. and Todrys, K. W. (2008) ‘Fear of foreigners: HIV-related restrictions on entry, stay, and residence’ Journal of the International AIDS Society 11, 8.
- Chang, F., Prytherch, H., Nesbitt, R. C. and Wilder-Smith, A. (2013) ‘HIV-related travel restrictions: trends and country characteristics’ Global Health Action 6, 20472.
- The global database on HIV-specific travel restrictions [Online] Accessed on 13 February 2013.
- Joint United Nations Programme on HIV/AIDS (2009) The Impact of HIV-related restrictions on entry, stay, and residence: Personal narratives. [Online] Accessed on 14 February 2014.
- Joint United Nations Programme on HIV/AIDS (2013), Global report: UNAIDS report on the global AIDS epidemic 2013.
- Lazarus, J. V., Curth, N., Weait, M. and Matic, S. (2010) ‘HIV-related restrictions on entry, residence and stay in the WHO European Region: A survey’ Journal of the International AIDS Society 13:2.
- Mahto, M., Ponnusamy, K., Schuhwerk, M., Richens, J., Lambert, N., Wilkins, E., Churchill, D. R., Miller, R. F. and Behrens, R. H. (2006) ‘Knowledge, attitudes and health outcomes in HIV-infected travellers to the USA’ HIV Medicine 7, 201-204.
- Raghavan, S. (2014) ‘Ugandan leader signs harsh anti-gay bill, ignores warning from Obama’ The Washington Post [Online] Accessed on 27 February 2014.
- Rushton, S. (2012) ‘The global debate over HIV-related travel restrictions: Framing and policy change’ Global Public Health 7(Supplement 2), S159-S175.
- Taylor, R. C. R. (2012) ‘The politics of securing obrders and the identitites of disease’ Sociology of Health & Illness 35, 241-254.
- Wiessner, P. and Lemmen, K. (2012) Quick reference guide: Entry and residence regulations for people living with HIV 2012/2013, 10th edition, Berlin: Deutsche AIDS-Hilfe e. V.
Author: Waldo Adams (BSc Hons Biochemistry)
Reviewed by: Hendra van Zyl (MPH) and Michelle Moorhouse (MBBCh, DA)
Date: March 2014
Adams, W. (2014) HIV-related travel restrictions on entry, stay and residence, AfroAIDSinfo. Issue 14 no. 3, Public (Open access).
4 March, 2014