Migrants no longer automatically excluded due to HIV status

Source: 1News

People with HIV will no longer be automatically denied the ability to live in New Zealand, a move the NZ AIDS Foundation called a step towards dismantling HIV stigma in immigration.

Airport arrival.

By Lillian Hanly

However, migrants are still required to take an HIV test as part of their medical tests for visas, a rule that some worry may put people off being tested for the disease in the meantime.

A man who did not want to be named, who is living with HIV in Aotearoa and is awaiting confirmation of a work visa, told 1News the change gives him hope.

While he still feels in limbo, he said it would make New Zealand a fairer place and reduce the ability for the system to discriminate over a medical condition.

Instead, individuals will now be assessed on a case by case basis, and still must undergo a test to secure a residency visa.

In the case of most temporary visas, there was a blanket ban for people living with HIV. Until now, HIV has been part of a list of medical conditions deemed by officials to likely cost more than $41,000 over a lifetime.

The New Zealand AIDS Foundation and Body Positive have been advocating to remove HIV from the list of high cost medical conditions for years, a change that would bring us a step closer to Canada who changed its rules 20-years-ago, and the US who ended their HIV-specific exclusion in 2010.

NZ AIDS Foundation chief executive Dr Jason Myers said the change brings New Zealand closer in line with the latest scientific and health developments.

"With appropriate treatment, people living with HIV who maintain undetectable viral load do not transmit the virus through sexual contacts and treating HIV in New Zealand no longer poses significant costs on the public health budget."

Body Positive, an organisation for those with HIV, have requested in the past for the cost threshold to be reviewed and updated, with the last review taking place in 2012.

Executive director Mark Fisher told the Government two-years-ago people living with HIV now have life expectancies on par with people not living with HIV.

He said the rule that was introduced in 2005 was stigmatising and demonstrated an outdated understanding of HIV.

Fisher told 1News the HIV immigration change was a step in the right direction.

"The advances in care enables people to live long and healthy lives and they are not a burden on the health system. Treatment prevents onward transmission which eliminates any public health concerns.

"Treatment costs [are] declining rapidly… as many patients move to generic medication," Fisher said.

PHARMAC’s chief executive Sarah Fitt said the current treatment for HIV, known as the Mylan regimen, costs about $3.50 a day.

"This now costs just over $100 for 30 tablets or less than $1500 per annum per patient. Its original list cost, when introduced in 2012, was just over $1,300 for 30 tablets."

A spokesperson for Immigration Minister Kris Faafoi told 1News the life expectancy and health outcomes of an individual living with HIV have improved dramatically in recent years, with HIV infection now considered a manageable chronic illness.

However, they stated HIV still presents a risk to public health as it is easily spread through unprotected sexual contact and sharing contaminated needles. While medical assessors will no longer apply a blanket rule to those applying for residency with HIV, they will continue to consider the specific medical circumstances of each individual with HIV.

The United Nations agreed in 2016 to eliminate HIV-related travel restrictions. As of 2019, the UN listed New Zealand as one of only 18 countries worldwide where testing or disclosure of the disease was required for work and residency permits.

In June 2021, New Zealand again agreed to eliminate stigma and discrimination by reviewing and revising restrictive rules, including HIV-related travel restrictions and mandatory testing.

Green Party Immigration spokesperson Ricardo Menendez March said the Government is only catching up to the rest of the world.

"For too long the Government has stigmatised migrants living with HIV and prevented them from being able to obtain visas on the basis of their diagnosis."

Menendez March was disappointed migrants would still be required to take a HIV test as part of their medical tests for visas.

"The existing policies also go against the Government’s commitments to Joint United Nations Programme on HIV/AIDS. These commitments clearly reject mandatory HIV testing and restrictions that limit or restrict movement based on an HIV-positive status."

He called the Government's health standards an 'ableist' regime, adding that the policy goes against the UN commitment that New Zealand signed up to.

Immigration NZ's chief medical officer Rob Kofoed wrote to the AIDS Foundation, saying they were pleased to remove HIV infection from the list, however, they would continue to include HIV testing as a requirement for visa applicants intending to stay in New Zealand for more than 12 months.

Body Positive is also concerned that mandatory testing will still be part of the medical examination. Fisher said it needs to be clear that HIV testing is about getting access to care, not as a barrier to residence.

Fisher sees this as a risk to public health as people don’t know their status, with greater risk of passing on HIV to others.

Kris Faafoi's office confirmed to 1News there were no further plans to change any other HIV related requirements for residency.