TWENTY YEARS ago, when fear and uncertainty still marked the public's reaction to AIDS, the federal government banned HIV-positive travelers from entering the United States. Since it has long been established that the virus cannot be transmitted through casual contact and can be successfully managed, the ban serves no public health purpose. It is merely discriminatory, and it has disqualified the United States as a site for some international AIDS conferences. It should be dropped.
A step in this direction is a bill by Democratic Senator John Kerry of Massachusetts and Republican Senator Gordon Smith of Oregon. They would repeal a 1993 measure that enshrined the ban in federal law. Authority over the admission of HIV-positive visitors and immigrants would return to the Department of Health and Human Services.
Although the bill calls for the department to review the public health aspects of restrictions on persons with the disease, some AIDS activists are skeptical that the department will come up with a policy that genuinely opens US doors to HIV-positive individuals. If the Kerry bill passes, he and other members of Congress must ride herd on HHS to make sure that any policies it adopts are in line with the UN guidelines on HIV/AIDS and human rights, which state that it is discriminatory and unjustifiable on public health grounds to restrict a person's movement or choice of residence based on HIV status. The United States is one of just 13 nations that have HIV travel bans. Others on this list include China, Iraq, Libya, and Sudan.
A particularly harmful effect of the current ban is that it undercuts the efforts of US programs in Africa and elsewhere to end the stigma associated with AIDS. Stigma often keeps individuals from getting tested for HIV. Testing is the first step toward treatment, and it can prompt people to stop practicing unsafe sex or using contaminated syringes.
In 2006, President Bush recognized that the ban was self-defeating and called on the Department of Homeland Security to improve the current waiver process, which is extremely difficult to negotiate. Critics of the ban, however, believe that the proposed new requirements for waivers still put applicants through humiliating hoops that shred their privacy rights. The proposals place much authority in the hands of consular officials with little medical expertise.
"There have never been public health grounds for denying people living with AIDS admission to the United States," said Frank Donaghue, chief executive of the Cambridge-based Physicians for Human Rights. At a time when public health officials all over the world are doing their best to normalize the treatment of this disease, ending the ban is just what the doctor ordered.
