Global Overview of
HIV-related Restrictions on
Entry, Stay and Residence
Steven J Kraus
Director, UNAIDS Regional Support Team for Asia and the Pacific
7th IAS Conference on HIV Pathogenesis, Treatment and Prevention
2 July 2013
What are HIV-related restrictions on entry,
stay or residence (“travel restrictions”)?
• Restrict entry, stay, work and/or residence
based on HIV status only
• Single out HIV for negative consequences
(making them discriminatory)
• Apply a blanket restriction against all
people living with HIV (making them
unreasonable)
• Can be a law, regulation, policy or
practice
What are HIV-related travel restrictions?
(continued)
• Not a new issue – most put in place in
the 1980s, a time of fear, ignorance
and prejudice about HIV
• Governments cite two reasons:
 To protect public health (“keep HIV
out”)
 To avoid costs associated with care,
support and treatment for people
living with HIV
Examples of restrictions
• Mandatory HIV testing and requirement to
show HIV-negative status in order to get visa to
enter or stay
• Requirement to disclose HIV status on visa
application forms and/or apply for special
“waivers” due to HIV status
• Sometimes applied to certain categories of
people: e.g. Africans, students, entertainers
• Detention or deportation of HIV-positive nonnationals on basis of HIV status
Examples of impact
• Company cannot post employee in certain
countries
• Person subject to testing in home country or
destination country without counselling,
informed consent, confidentiality
• Economic loss, job loss, study loss
• Loss of dignity, emotional distress
• Detention, sometimes without treatment
• Summary deportation without due process or
economic fairness
• Denial of asylum, family unification
Current state of restrictions
131 countries, areas have no HIV-specific restrictions
44 countries, areas have some form of restriction (see below);
1. Andorra
2. Aruba
3. Australia
4. Bahrain
5. Belarus
6. Belize
7. Brunei Darussalam
8. Comoros
9. Cuba
10. Cyprus
11. Democratic People’s
Republic of Korea
12. Dominican Republic
13. Egypt
14. Iraq
15. Israel
16. Jordan
17. Kuwait
18. Lebanon
19. Lithuania
20. Malaysia
21. Marshall Islands
22. Mauritius
23. New Zealand
24. Nicaragua
25. Oman
26. Papua New Guinea
27. Paraguay
33. Slovakia
34. Solomon Islands
35. Sudan
36. Syrian Arab Republic
37. Chinese Taipei
38. Tajikistan
39. Tonga
40. Turkmenistan
41. Turks and Caicos Islands
42. United Arab Emirates
43. Uzbekistan
28. Qatar
29. Russian Federation
30. Samoa
31. Saudi Arabia
32. Singapore
44. Yemen
Map of HIV-related restrictions on entry, stay and residence as of January 2013
Travel Restrictions are irrational
• Do not protect public health (can harm it by creating false
perception that government policy keeps HIV outside therefore
no need to take precautions); do not “keep HIV out”
• HIV is not contagious and people can protect themselves
• The world is “smaller” and movement more important
• HIV treatment = long, productive lives
• HIV treatment = being non-infectious
Policy and human rights considerations
• Countries can exclude entry based on proof of becoming
undue economic burden
• However, every individual should have equal access to
freedom of movement within countries, and the right to
non-discrimination on grounds of health status is
increasingly being considered relevant to countries’
requirements for entry, stay and residence.
• Humanitarian concerns should always supersede
economic considerations.
Towards “Zero Discrimination”: momentum to
eliminate HIV-related travel restrictions
• WHO, UNAIDS, IOM and the Global Fund have
called for removal
• In 2011 Resolution, Human Rights Council
• At AIDS2012, global business leaders issued a call for the
elimination of restrictions (over 50 of world’s largest
companies have signed on)
• Since 2010, 9 countries have lifted travel restrictions:
Armenia, China, Fiji, Namibia, Republic of Moldova, Mongolia,
Republic of Korea, Ukraine, and the United States of America
Commitments to remove restrictions by 2015
In the 2011 Political Declaration on HIV,
governments of 192 Member States
committed to:
“identifying and reviewing any
remaining HIV-related restrictions on
entry, stay and residence so as to
eliminate them.”
UNAIDS Advocacy and Action Toolkits
Two toolkits to support multi-sectoral coalitions to engage in advocacy and action to
eliminate HIV-related restrictions on entry, stay and residence:
In your own country
In migrant receiving countries
Global Commission on HIV and the Law
14 eminent world leaders. 18 months of evidence-gathering and analysis.
Recommendations included:
•
In matters relating to HIV and the law, countries should
offer the same standard of protection to migrants, visitors
and residents who are not citizens as they do to their own
citizens.
• Countries must repeal travel and other
restrictions that prohibit people living with HIV
from entering a country and/or regulations
that mandate HIV tests for foreigners within a
country.
•
Countries must implement regulatory reform to allow for
legal registration of migrants with health services and to
ensure that migrants can access the same quality of HIV
prevention, treatment and care services and commodities
that are available to citizens. All HIV testing and STI
screening for migrants must be informed and voluntary, and
all treatment and prophylaxis for migrants must be ethical
and medically indicated.
Role of scientists and the medical and public
health community
• Actively support advocacy for removal of
travel restrictions as a public health measure
• Advocate for evidence informed HIV laws and
policies