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HIV is HIV - is what is is..isn't it? Obama (TRAVEL BAN, 2010)
Mar 29, 2010

Hi Doc!!

HIV is what is is: an incredible danger. Why, then, are some body fluids more infectious than others? If a person has got HIV, than they've got HIV and that's it! Anything can be infectious! The virus in the blood is still the same as in salaiva and nasal secretion..because it's all over a person! So, why wouldn't it be a worry?

I admit that I am hoping it is not a worry. I went to a store and after grabbing a cart, I looked at my hand. Snot all over my thumb and forefinger! All I can think of was 'this better be mine, for Christ sake!' But I don't remember wiping my face with my hand before grabbing the cart for any reason. I also know that people can be absolute pigs and I can see someone wiping it (anything)on a surface. I don't think there was blood in in the snot. I don't know, though. I odn't think my skin is open. Just dry. I don't know.

I can't think, I'm just so angry that people behave like animals..

And about Obama..don't see why he's letting poz ppl into the country? Isn't that making a bad situation worse here? I am not trying to sound mean...just wondering.

Thank you!

Response from Dr. Frascino

Hello,

You are incredibly misinformed abut HIV/AIDS on multiple levels.

Fact: Not all bodily fluids are infectious for HIV. Sweat, tears, nasal mucous, urine, vomitus and feces that do not contain visible blood are not considered infectious for HIV! We've intensively studied HIV, bodily fluids, and HIV transmission and for well over a quarter of a century. Despite your assumptions or fears, facts are facts.

Fact: Your fears concerning acquiring HIV from touching nasal mucous are unwarranted. A handful of snot is not a risk for HIV transmission/acquisition.

Fact: Rescinding the travel ban for HIV was the correct and moral thing to do. The ban was discriminatory and was based on irrational fear rather than science. (See below.)

I strongly suggest you spend time reviewing the information on this site and related links. You have much to learn about HIV and at present you are harboring many misconceptions that could lead to unwarranted fears and anxieties.

Be well. Get informed!

Dr. Bob

Travelling to the USA with HIV Mar 11, 2010

Hi, I have been offered to go on a holiday to Florida in 6 months time and am unsure of the law regarding HIV. I have been on the US embassy site whish states i would require a visa as i have HIV. I have also read on this site that the ban has been lifted for HIV travellers to the USA and would not require a visa. Which should i believe? as this is very confusing to myself.

J. Scotland

Response from Dr. Frascino

Hi J. from Scotland,

The ban has indeed been lifted. Yeah Obama! See below.

Dr. Bob

HIV TRAVEL BAN Nov 1, 2009

Hey Dr. Bob,

What's up with the HIV travel ban? Didn't Obama promise to get that cancelled???

Flying Monkey

Response from Dr. Frascino

Hi,

Obama promised and Obama delivered! The 22-year ban on travel to the U.S. by HIVers was abolished by Obama yesterday (10/30/09) and will go into effect after a routine 60-day waiting period. The unscientific discriminatory travel ban was the handiwork of hateful Republican Senator Jesse Helms who singlehandedly set HIV/AIDS awareness, education and prevention back by decades. The ban's repeal was spearheaded by Senator John Kerry and other Democrats. Once again, it's important to note elections do matter!

I'll post some information below from the New York Times that discusses the repeal of the travel ban.

Dr. Bob

Obama Lifts a Ban on Entry Into U.S. by H.I.V.-Positive People October 31, 2009

By JULIA PRESTON, New York Times

President Obama on Friday announced the end of a 22-year ban on travel to the United States by people who had tested positive for the virus that causes AIDS, fulfilling a promise he made to gay advocates and acting to eliminate a restriction he said was "rooted in fear rather than fact."

At a White House ceremony, Mr. Obama announced that a rule canceling the ban would be published on Monday and would take effect after a routine 60-day waiting period. The president had promised to end the ban before the end of the year.

"If we want to be a global leader in combating H.I.V./AIDS, we need to act like it," Mr. Obama said. "Now, we talk about reducing the stigma of this disease, yet we've treated a visitor living with it as a threat."

The United States is one of only about a dozen countries that bar people who have H.I.V., the virus that causes AIDS.

President George W. Bush started the process last year when he signed legislation, passed by Congress in July 2008, that repealed the statute on which the ban was based. But the ban remained in effect.

It was enacted in 1987 at a time of widespread fear that H.I.V. could be transmitted by physical or respiratory contact. The ban was further strengthened by Congress in 1993 as an amendment offered by Senator Jesse Helms, Republican of North Carolina.

Because of the restriction, no major international conference on the AIDS epidemic has been held in the United States since 1990. Public health officials here have long said there was no scientific or medical basis for the ban.

Under the ban, United States health authorities have been required to list H.I.V. infection as a "communicable disease of public health significance." Under immigration law, most foreigners with such a disease cannot travel to the United States. The ban covered both visiting tourists and foreigners seeking to live in this country.

Once the ban is lifted, foreigners applying to become residents in the United States will no longer be required to take a test for AIDS.

In practice, the ban particularly affected tourists and gay men. Waivers were available, but the procedure for tourists and other short-term visitors who were H.I.V. positive was so complicated that many concluded it was not worth it.

For foreigners hoping to immigrate, waivers were available for people who were in a heterosexual marriage, but not for gay couples. Gay advocates said the ban had led to painful separations in families with H.I.V.-positive members that came to live in this country, and had discouraged adoptions of children with the virus.

Gay advocates said the ban also discouraged travelers and some foreigners already living in the United States from seeking testing and medical care for H.I.V. infection.

"The connection between immigration and H.I.V. has frightened people away from testing and treatment," said Rachel B. Tiven, executive director of Immigration Equality, a group that advocates for gay people in immigration matters. She said lifting the ban would bring "a significant public health improvement."

"Stigma and exclusion are not a sound basis for immigration policy," Ms. Tiven said.

Senator John Kerry, Democrat of Massachusetts, who led the effort to repeal the ban, said it had now "gone the way of the dinosaur."

But, Mr. Kerry added, "it sure took too long to get here."

International health officials said lifting the ban would end a much-criticized inconsistency in United States health policy, with Washington playing a leading role in AIDS prevention in Africa and other countries with severe epidemics, but preserving restrictions that in practice prevented international AIDS researchers and activists from gathering at conferences here.

In 1989, a Dutch AIDS educator, Hans Verhoef, was detained for several days in St. Paul when he tried to attend a conference. Since then, people involved with AIDS issues have not organized meetings here.

"We think this is going to give a very positive image of where the United States is going in terms of eliminating stigma and discrimination in relation to H.I.V.," Dr. Socorro Gross, assistant director of the Pan American Health Organization, said Friday.

Entry forbidden (TRAVEL RESTRICTIONS) (TRAVEL BAN) Jan 7, 2008

Dear Doctor Robert I'm a 32 year old Brazilian hiv positiv male living in London. After 5 years in the UK I must say that I really admire their aproach to us positive people. We're treated by their government like anybody else if no better. I've traveled all over Europe and have never had a problem regarding my hiv status. I'd love to go to New York though, but I find it so hard because of your rules towards positive people. My question is: Why is the mainstream of hiv activism in America so silent about this matter? Why don't you people raise your voices to make sure that your next presitent fights against such totalitarian law. How come a people that think of themselves as the kingdom of freedom and an example to the world can accept it? I shall never see New York unless I hide my meds like a terrorist hides his bomb. How come you hiv positive people from America can so easily go on holiday to any other corners of the world? Thanks for your answer. Helio

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Response from Dr. Frascino

Hello Helib,

I can assure you mainstream HIV activism in the U.S. has been far from quiet about the completely idiotic ban on HIV-positive visitors to the U.S. In fact, since the ban was put in place, we have refused to host international World AIDS Conferences here. The problem is our current science-phobic, common-sense-deficient administration. See below. We are all gleefully counting down the days left before we can kick Dubya out of the White House. I'm quite confident once Obama moves in, rational thought, common sense and morality will be restored to the Office of the Presidency and the travel ban will be lifted.

Dr. Bob

New Rules for HIV positive people travelling to the United States Dec 10, 2007

Hey Dr. Bob,

I heard the Bush Administration finally got around to changing the ban on HIV positive travelers wanting to come to the Unioted States. Is this too good to be true???

Toby

Response from Dr. Frascino

Hello,

Dubya strikes again! Or should that be strikes out again?!?!

The new rules for HIV-positive folks wishing to enter the U.S. are even worse than the old rules!

People with HIV have been banned from entering the U.S. since 1987, but waivers are sometimes given for short visits. Dubya promised to "streamline" the process for getting these exceptions on World AIDS Day last year! So, one year later we have Homeland Security, which had handled the waivers on a case-by-case basis in the past, drawing up new rules that can be followed by consulates. The new rules are no better than the old ones and, in some ways, make visiting the U.S. even more difficult. Dubya, in typical fashion, is also trying to ram the new rules through without the usual time for public comment and consideration.

Basically the ban remains in place. The new rules apply only for exceptions to the ban. I should point out scientists have long ago concluded the ban is unwarranted and does absolutely nothing to protect Americans' health. Only a dozen other countries bar HIV-positive visitors. They are Armenia, Brunei, China, Iraq, Libya, Moldova, Oman, Qatar, Russia, Saudi Arabia, South Korea and Sudan. This is not exactly a stellar list when it comes to human rights! The ban stems from stigma and ignorance. (Hence the good fit with Dubya, eh?)

Current waivers to the ban have been very difficult to get and are issued rather capriciously. Under the old rules, the possibility of transmission and the danger to public health had to be minimal and no local, state or federal government agency could incur costs from the visit. The new system makes it more difficult to enter the U.S. by requiring more documents. The old system required very few papers, but under the new "streamlined" plan, visitors must document very private information about their health to bureaucrats. As an example, the new system would require the potential visitor to carry medications they might need for the entire stay. Someone who doesn't take any medications would have to get a doctor to certify to Homeland Security that meds aren't needed. Waivers would now also require that the visit be a maximum of 30 days and that applicants prove they are aware of their condition and under medical care. Plus they would have to prove they have health insurance that is accepted in the United States! Needless to say, these requirements are unjust, illogical and stigmatizing!

The new rules do call for waivers to be granted faster, but only if applicants agree to give up certain rights and opportunities they might have had under the old system. The quicker turnaround is expected because consular offices would be able to process the applications directly and the process avoids the abyss of the Homeland Security office. Basically what HIV-positive travelers would have to give up is the opportunity to change their visa status while here in the U.S., to seek legal permanent residency, to apply for a job and, in some cases, to conduct business while in the U.S. They also would no longer be able to seek asylum.

Dubya and his cronies are once again being disingenuous by claiming to make things easier for people living with HIV, but in reality compelling them to forfeit their rights.

So, is it January 20, 2009 yet???

Dr. Bob

Is still banned to get in USA with HAART? (TRAVEL RESTRICTIONS, ENTERING THE USA) Nov 7, 2007

Hi there, Id like to know if there has been any kind of improvement in order to let people using HAART to get into the country of freedom (USA I mean... :-( ) I need urgently to get there for job reasons but Ive been succesfully on the same combo for 8 years and I am extremely annoyed of the idea of put that in risk.. could i get my haart recipe and buy the combo in usa being from abroad? Thanks in advance Antonio

Response from Dr. Frascino

Hello Antonio,

Unfortunately no, Bush had promised to lift the ban, but apparently hasn't gotten around to it yet. Don't hold your breath. There may well be no action on this until he is run out of office and firmly ensconced in the history books as America's worst president. After all, to lift the ban would require common sense, compassion and an appreciation of scientific fact. Dubya has a severe deficiency of all three. At this point your only option would be to apply for a waiver.

I'll reprint some information from the archives below addressing this issue.

Dr. Bob

Travel to the US Sep 14, 2007

Hi,

I am ravelling to the US for 1 week next month and am wondering if the HIV waiver is in place or not - should I take a treatment break, declare my status or simply risk bringing in my meds for the week without declaring.

I'm not willing to post my med in beforehand as many here in Australia recommend - just too difficult.

David

Response from Dr. Frascino

Hi David,

I do not recommend you take a treatment break. Just pack your meds in your carryon. You shouldn't have any difficulties. Bush vowed to lift the travel ban on World AIDS Day 2006. Whether he actually did so is another story. (See below.) But, I've not heard of anyone being turned away for quite some time.

Bon voyage!

Dr. Bob

Advocates take on U.S. HIV 'travel ban' NEWS Published 04/19/2007 by Bob Roehr

The U.S. "travel ban" on HIV-positive foreign visitors and immigrants is a vestige of the darkest days of the epidemic. It may be drastically modified or even eliminated completely if the organizers of an April 12 forum in Washington, D.C., have their way.

U.S. authorities always have had the power to bar foreigners who pose a public health threat from entering the country. That was interpreted to exclude a HIV-positive Dutch visitor traveling to speak in the U.S. in 1989. It sparked a protest at the International AIDS Conference in San Francisco in 1990 and the conference vowed not to return until U.S. policy changes. The World Health Organization has called the policy a violation of human rights.

But Congress codified the policy into law in 1993, despite objections from then-Secretary of Health and Human Services Louis Sullivan. It specifically prohibited foreigners from becoming immigrants or even obtaining a visa to visit the U.S. if they are HIV-positive. However, the provision may be waived on an individual basis if it is deemed to be in the best interest of the U.S. to do so. Blanket waivers have been issued for specific events such as the Gay Games in Chicago.

Attending the International AIDS Conference in Toronto last summer "brought home in a very powerful and real way that it is forbidden to have such a thing on U.S. soil," said J. Stephen Morrison, executive director of the Center for Strategic and International Studies. He said the U.S. policy "is misaligned with current realities and evolving U.S. interests;" and that it is time to consider a change.

Phillip Nieburg, co-author of a report that lays out the history of the policy and how it might be changed, said that the knowledge base around HIV has grown since 1993 and it is clear that HIV is not an easily spread contagious disease. There is no public health justification for the law, he said.

Helene Gayle has been a leading expert on HIV prevention at the Centers for Disease Control and Prevention and the Gates Foundation, and is now president of CARE, a large international charity working in the developing world.

She said the law is not consistent with the international leadership role on HIV that the U.S. has demonstrated with PEPFAR, the President's Emergency Plan for AIDS Relief.

"It is just one more thing where we are out of line and inconsistent with what we are trying to do," she said.

Critics of the waiver process for short-term visitors say that many persons do not know that they are HIV-positive when they apply for a visa. For those who do know, disclosing that to a State Department official runs the risk that the official or local support staff might disclose that medically confidential information. In many countries, that can lead to stigma and discrimination within the society. Furthermore, the application fee for the waiver can be prohibitive for persons with low incomes.

The Bush administration acknowledges the privacy concerns and on World AIDS Day, December 1, 2006, President Bush surprised AIDS advocates by quietly announcing that he would issue an executive order addressing those concerns.

Rising from the audience last week, Tom Walsh, with the Office of the U.S. Global AIDS Coordinator at the Department of State, told the forum, "The process is under way, it is complex, and I wish there was more that I could say." Others have said that delay is due to trying to work within the confines of the law so as not to require new legislation.

Supporters of the current law fear that people who are HIV-positive who enter the country either as immigrants or on short-term visas will stay and add to the burden of already stressed AIDS services. They can point to what happened after the International AIDS Conference in Toronto last summer; more than 150 HIV-positive attendees chose to remain in Canada and seek asylum. The claimants said they feared discrimination or worse in their own countries. The cost of drugs alone for those people would run about $1 million a year in the U.S.

Nieburg called that argument inherently discriminatory, given that other costly chronic health problems are not singled out for a blanket ban but are handled on a case-by-case basis.

"Moving Beyond the U.S. Government Policy of Inadmissibility of HIV-Infected Noncitizens" is available at http://www.csis.org/media/csis/pubs/movingbeyondinadmissibility.pdf.

Entering the US Jun 4, 2006

Am I correct in saying that you can't enter the US period if you have AIDS or just immigrate to the US because I recently entered the US through SFO international on business for 3 days and I have HIV, not AIDS though since am on meds.

Response from Dr. Frascino

Hello,

I've addressed travel restrictions several times in this forum. I'll repost a recent question from the archives below.

Dr. Bob

Living with HIV May 14, 2006

Dear Dr. Bob,

I am from Brazil, 26 years old and a handsome gay man. Your words are always very inspiring for me. I got HIV around three years ago, when a condom failed with me. The beginning was not easy... after 1 year my cd4 was around 200 but I was healthy. I started to take my meds since 05.05.05. It was very boring the side effects of efavirenz+lamivudine+azt, but now it is not anymore. However my cd4 is still around 240, however, the cd4 percentage has climbed from ca. 20 to 30 %. I am indetectable since Aug '05. I never forgot any pill. Is these number ok? My doctor and me are planning to move on kaletra (once a day). Do you think it should be a better option? I am finishing my phd and would like to go to USA for a post-doc. Is it possible for me enter in The States being poz? How is the medical care? I am worried because I have full and free assistance in Brazil. Again, thank you very much for your very kind words at this site. Best regards,

Bob

Response from Dr. Frascino:

Hello Bob,

Your current HAART regimen appears to have given you a good virological response (decreased viral load to undetectable levels), but only a suboptimal immunological response (minimal increase in absolute CD4 count from 200 to 240). I believe a switch from the non-nucleoside (efavirenz) to a protease inhibitor (Kaletra) is definitely worth a try.

Traveling to the US while being "virally enhanced" can be challenging! Despite absolute consensus among all experts that HIV travel bans are completely unnecessary (read this PDF file for more information), the U.S. still shuts its borders to visitors with HIV. The United States Citizenship and Immigration Service (USCIS) sometimes grants a waiver for HIV-positive visa applicants, but usually it's for those wanting to stay 30 days or less.

There is no actual HIV-testing procedure at the airport, but travelers carrying HIV-related literature or HIV medications can be turned over to an immigration official for further investigation. If a determination is made by the immigration officer that the traveler is HIV positive and traveling without the proper HIV-waiver clearance, he or she can legally be barred from entry into the U.S. ( I find this policy shameful!) Before making definitive plans, I suggest you consult with an immigration practitioner who is familiar with the HIV-travel restrictions. (You can call AIDS Law Project at 215-587-9377 for a consultation.) I'm hopeful that once we have a regime change here and Bush and his anti-science cronies are finally removed form office, common sense and science will once again reign and we'll be able to change some of these nonsensical laws.

Dr. Bob



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