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Signs of Change: Ryan White Reauthorization, Travel Ban Removal

By Bonnie Goldman

November 5, 2009

People in the HIV/AIDS community could be forgiven for thinking that, despite the election of Barack Obama, they still did not have a close friend in the White House.

After all, despite all the recent cacophony about health care reform, HIV/AIDS has not been mentioned. In fact, apart from Obama's widely praised selection in February 2009 of Jeffrey Crowley, M.P.H., to lead the Office of National AIDS Policy (ONAP), and the subsequent commencement in August of a series of ONAP community meetings throughout the U.S. (and establishment of the energetic office and Web site), there's been little direct comment about HIV/AIDS by President Obama since he came into office.

This has been somewhat disconcerting, given the long silence about domestic HIV throughout the entire eight years of the Bush administration, and given the devastation occurring in Obama's new backyard of Washington, D.C., where up to 3 percent of residents are estimated to have HIV.

Announcement #1: Ryan White CARE Act Renewed

This was the scenario that set the stage for what happened on Friday, Oct. 30. I was attending the United States Conference on AIDS in San Francisco and was at a breakfast with 400 or so other conference attendees, most of whom were HIV/AIDS educators, people living with HIV, health department workers, case managers and the like. There was a wide screen set up on a stage so that we could watch a live, streaming video of a speech that President Obama was to give as he signed a renewal of the Ryan White Comprehensive AIDS Resources Emergency (CARE) Act.

I think everyone in the room was ready, even impatient, for this moment. Ready for Obama to reveal that he was on our side. And he didn't disappoint. In fact, he clearly was using HIV insider language in his speech -- the same language we within the community use when speaking to one another: "It has been nearly three decades since this virus first became known," he said. "But for years, we refused to recognize it for what it was. It was coined a 'gay disease.' Those who had it were viewed with suspicion. There was a sense among some that people afflicted by AIDS somehow deserved their fate and that it was acceptable for our nation to look the other way."

When he talked about the importance of the Ryan White CARE Act, he once again mentioned the LGBT [lesbian, gay, bisexual and transgender] community. And every time he says it, we need to remember that Obama could be the most important friend in the White House the HIV community has ever had.

"You know, over the past 19 years this legislation has evolved from an emergency response into a comprehensive national program for the care and support of Americans living with HIV/AIDS," said Obama about the CARE Act. "It helps communities that are most severely affected by this epidemic and often least served by our health care system, including minority communities, the LGBT community, rural communities, and the homeless. It's often the only option for the uninsured and the underinsured. And it provides life-saving medical services to more than half a million Americans every year, in every corner of the country."

He even mentioned HIV/AIDS stigma, reminding viewers that "it will also take an effort to end the stigma that has stopped people from getting tested; that has stopped people from facing their own illness; and that has sped the spread of this disease for far too long."

Announcement #2: The End of the HIV Travel Ban

And then came an unexpected surprise: Obama announced the final dismantling of the ignorant and illogical 22-year-old ban on HIV-positive tourists and immigrants entering the U.S.

"Twenty-two years ago, in a decision rooted in fear rather than fact, the United States instituted a travel ban on entry into the country for people living with HIV/AIDS," Obama said.

"Now, we talk about reducing the stigma of this disease -- yet we've treated a visitor living with it as a threat. We lead the world when it comes to helping stem the AIDS pandemic -- yet we are one of only a dozen countries that still bar people from HIV from entering our own country. If we want to be the global leader in combating HIV/AIDS, we need to act like it. And that's why, on Monday [Nov. 2], my administration will publish a final rule that eliminates the travel ban effective just after the New Year."

There are a multitude of meanings to this change. The ban was meaningless for many HIV-positive tourists who didn't need visas to enter the U.S. Many HIV-positive tourists from Great Britain, France, Italy and Spain, for example, freely traveled back and forth between the States and their home countries. For the most part, they didn't worry about the possibility that someone would notice their HIV meds and pull them aside. One man I know used to FedEx his meds to his friend in New York so they were waiting when he arrived. Others hid their pills in an aspirin bottle.

But the vast majority of HIV-infected people who needed visas, or who were hoping to apply to get green cards, etc., were denied entry to the United States. You see, anyone who wants to immigrate to the U.S. is required to take an HIV test. This rule even affected people who already had green cards and wanted to leave the U.S. for a short time. They worried that they would not be able to reenter the country because of their HIV.

"At long last, people living with HIV will no longer be pointlessly barred from this country," said Rachel Tiven, who is the executive director of Immigration Equality, an organization that has been working with many people denied entry because of HIV. "Every day, Immigration Equality hears from individuals and families who have been separated because of the ban, with no benefit to the public health. Now, those families can be reunited."

Immigration Equality put together this handy list of frequently asked questions about the elimination of the HIV travel ban. will certainly be covering the ramifications of the removal of this ban. Clearly, the removal of the ban will help so many people living with HIV. And it also will finally allow U.S. residents working in HIV/AIDS to once again hold their heads up high.

Yet, I have to admit, although some organizations worked tirelessly to bring this change about, it still bugs me that for all these years, this embarrassing law stayed on the books. One cannot help but feel that if there was more AIDS activism, we could've gotten this law changed long ago. As a result of this law being on the books for 22 years, thousands of people with HIV were humiliated at our borders and had to endure discrimination over the years. Maybe this move will help alleviate some of the enormous stigma associated with HIV/AIDS.

Copyright © 2009 Body Health Resources Corporation. All rights reserved.

See Also
More on U.S. Immigration Restrictions for People With HIV/AIDS


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On My Mind

Bonnie Goldman

Bonnie Goldman

Bonnie Goldman was's editorial director from its founding in 1995 until January 2010. Previously she was a book editor, journalist and HIV/AIDS activist.

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