The federal government recently took actions intended to make it easier for people with HIV to travel and immigrate to the United States. But the ban on HIV-positive immigrants remains on the books while the lengthy rulemaking process goes on, and the new rule for HIV-positive travelers still puts up substantial barriers.

When Congress renewed the President’s Emergency Plan for AIDS Relief (PEPFAR) this summer, it revoked the 1987 law that put HIV on the list of diseases that bar a person from entering the United States. The HIV Medicine Association (HIVMA) has long advocated for lifting the ban because there is no public health rationale for excluding people with HIV.

But revoking the law that put HIV on the list was only the first step. The Department of Health and Human Services (HHS) still must rewrite the rules to take HIV off the list. In a letter to HHS Secretary Michael Leavitt, HIVMA urged HHS to act swiftly to end the ban. Centers for Disease Control and Prevention Director Julie Gerberding, MD, MPH, wrote a letter to the editor of the Washington Post saying HHS intends to do so and has begun the rulemaking process, but she cautioned that the process takes time.

Meanwhile, the Department of Homeland Security has released a new rule that is intended to streamline the process of entry for HIV-positive visitors. Currently, short-term visitors can apply for a waiver under an intrusive and cumbersome process.  The new visa rule allows people with HIV to travel to the United States for no more than 30 days without a waiver.

The decision to grant a visa rests with the consular officer, however, who is unlikely to have much useful knowledge about HIV disease and must determine that applicants have no symptoms of active infection, have been counseled on how HIV is transmitted, and have sufficient medications for the duration of their stay. Furthermore, applicants must have the resources or insurance to pay for their health care while they are in the United States. Those admitted to the United States under this visa may not apply to become residents or even extend their stay.

HIVMA opposed these provisions during the rulemaking process and continues to do so.

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