Importing HIV: does it matter?

For 15 years, the United States has tried to bar its doors to immigrants with HIV. Like most decisions related to HIV in the States, that one was motivated more by political expediency than by common sense. It seemed to play to fears that if immigrants with HIV came to the States, they’d start spreading the filthy virus around among good, upstanding citizens. Has there ever been any evidence to support those fears? It’s a question worth asking, now that the US is considering dropping the restrictions.

Britain and Canada haven’t had such bans (in fact, the US is one of only 13 countries that erects barriers to the HIV-infected — the ban puts it in the good company of such beacons of openness as Libya, Iraq and Saudi Arabia). Have they been flooded with imported HIV?

Some in the loopier fringes of the bloggosphere, would answer with a resounding yes. In sheer numbers, the answer is certainly no. Canada welcomed over 2,400 immigrants that it knew had HIV between 2002 and 2006, according to an immigration official quoted in the Calgary Sun. That’s peanuts when set against the 1.2 million people who flooded into the country in that time. But in fact, it’s not an insignificant proportion of the estimated 58,000 Canadians with HIV (pdf). Overall, Canada estimates that around 12% of people with HIV are from countries, mostly in East and Southern Africa, where HIV is endemic. And they represent 45% of all heterosexually acquired infections in Canada. In the UK, it’s a lot higher. Over four in five heterosexual infections diagnosed in Britain are in people born in sub-Saharan Africa, and we see a similar pattern in Ireland.

We can’t say exactly where people picked up their infection. But if they grew up in Swaziland (where 43% of adults are infected with HIV) but were diagnosed in the UK (where infection rates are less than a hundredth of that), we can take a pretty good guess. In most countries that don’t bar HIV positives, there seems to be a distinction between imported HIV and new infections at home; those are still mostly in gay men and drug users in Britain, Canada and Ireland. The experience of these other countries would suggest that the US is not going to be mowed down by a wave of secondary HIV spreading out from a pebble of infection brought in by immigrants. So change the law, already!

This post was published on 26/03/08 in Ideology and HIV.

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  1. Comment by Chris Green, 30/03/08, 04:09:

    It is interesting that there is frequent reference to “only 13 countries that erect barriers…”. In fact, according to the very useful EATG :: Travel restrictions web site :

    “We are aware of 15 Countries that currently deport HIV positive foreigners: Armenia, Bahrain, Brunei, China, Cuba, Egypt, Iraq, North and South Korea, Kuwait, Libya, Malaysia, Oman, Russian Federation and Taiwan,.. and 12 countries that totally forbid PLWHA access and residence: Armenia, Brunei, China, Iraq, Qatar, South Korea, Libya, Moldova, Oman, Saudi Arabia, Sudan and the USA.”

    Interestingly, this does not include Singapore, for which the Immigration Act notes the following:

    “The following persons are members of the prohibited classes: … any person suffering from Acquired Immune Deficiency Syndrome or infected with the Human Immunodeficiency Virus”.

    We are aware of three recent cases in which foreigners have been summarily deported from or refused entry to Singapore because they were known to be HIV-positive. Singapore (being Singapore) has a very efficient immigration database, and those known to be HIV-positive are blacklisted in the computer.

    This raises an important point missed in your comment: that these countries (including the US) not only refuse residence to foreigners with HIV, but deny them entry even just for a tourist visit (or indeed medical treatment for which they are willing to pay – handsomely!).

    To add insult to injury, the US recent relaxed rules which previously denied overseas postings to HIV-positive foreign service employees. So they are willing to ‘impose’ their infected people on other countries, but deny entry (even for short visits) to people from those countries. Talk about hypocrisy!


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