San Francisco Chronicle - December 6, 2007
Sabin Russell, srussell@sfchronicle.com.

Laws dating back to the early days of the AIDS epidemic in the United States forbid issuance of visas to foreigners infected with HIV, but allow exceptions through a cumbersome waiver process that has been denounced as slow, arbitrary and unfair. In December 2006, President Bush asked for new administrative rules to speed up the granting of such waivers.

Opportunities for the public to comment on the regulations, which took 11 months to craft, expire Thursday, and opponents are using the deadline to criticize the suggested changes as well as the entire notion that people infected with the AIDS virus need special visas to visit the country.

Dr. Paul Volberding, chief of medicine at the VA Medical Center in San Francisco and an adviser to Physicians for Human Rights, a Cambridge, Mass.-based advocacy group, contends that the new regulations may be more discriminatory than the current rules. "Our citizens travel to other countries for pleasure and business without restrictions," he said. "But we erect barriers against those from other countries for a chronic, treatable disease that is not casually spread."

The new regulations proposed by the Department of Homeland Security would remove one requirement, widely recognized as onerous, that applications for waivers be reviewed by the U.S. Citizenship and Immigration Services. The decisions to grant or deny waivers would be left to U.S. consular officials in foreign countries - and that would cut red tape.

Critics contend, however, that the new rules are adding a requirement that travelers prove that they are bringing "an adequate supply of antiretroviral medicines" on their trips to the United States.

"Now we have people looking over their shoulders, not only at the diagnoses, but how they are being treated," said Volberding. "I would say that is laughable, if it wasn't such a serious thing."

Volberding also fears that requiring local decisions on waiver applications could foster discrimination, because travelers will have to make their HIV status known to consular offices in their communities, not to some distant embassy.

Department of Homeland Security officials nevertheless insist that the new regulations will improve the process. Veronica Nur Valdes, a department spokeswoman, said local consular agents will determine whether an applicant for a waiver has "a controlled state of HIV infection."

Valdes also contends that current rules already require that HIV-positive visitors granted a visa with a waiver "must be traveling with an adequate supply of drugs."

Victoria Neilson, legal director for Immigration Equality, a gay rights group in New York, said the HIV-waiver requirements are outlined in a 2002 Department of Justice memorandum. "There is nothing in there about traveling with meds," she said.

Neilson said that when the Bush administration announced the plan a year ago, it was her understanding that the process would be streamlined and simplified.

The proposed changes actually appear to toughen the rules in some cases, she said. For example, in order to get a waiver under the new process, the applicants will have to agree that they won't try to extend their stays once they are here. Visits are limited to two, 30-day stays per year, and any violation of the terms of the waiver could result in a permanent ban from re-entry to the United States.

Because of the U.S. visa restrictions for the HIV-infected, the International AIDS Society has refused to convene its semi-annual AIDS conference in the United States since the one held in San Francisco in 1990.

Occasionally, federal authorities have granted short-term exceptions, issuing waivers to allow HIV positive researchers to attend scientific meetings, or providing blanket waivers to allow tourists to visit the Salt Lake City Olympics in 2002, and the Gay Games in 2006.

AIDS advocates were encouraged one year ago when U.S. Global AIDS Coordinator Dr. Mark Dybul announced the streamlining plan. "This administration is very serious about fighting discrimination on AIDS," he said.

But after the State Department - which runs the President's Emergency Plan for AIDS Relief - set the goal, the issue was taken up by the Department of Homeland Security, which has ultimate responsibility for issuing visas to foreign tourists and business travelers.

Susannah Sirkin, deputy director of Physicians for Human Rights, said that only 13 nations in the world impose similar restrictions on HIV-positive travelers. "These policies are totally counterproductive to our own country's programs to address the global AIDS crisis," she said. "To put possibly more restrictive policies on the table does not serve any public health interest."

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