Key Point
- Advocates say some immigrants are postponing HIV testing for fear it could interfere with visa applications.
- Data show that immigrants are more likely to have a late-stage HIV diagnosis.
- The immigration minister said Australia’s migrant health requirements did not meet community expectations.
Proponents hope that Immigration Minister Andrew Giles’ remarks about Australia’s immigration health settings not working optimally signal a change in approach.
Giles said he is aware of the concerns of those in the HIV/sexual health field that temporary visa holders are afraid to test for HIV for fear it could negatively impact their permanent residency applications.
“Australia’s approach to migrant health requirements does not meet community expectations,” he told SBS News.
“We see this almost every week in personal decisions to intervene in the visa system through ministerial intervention.”
Giles said that since taking over the immigration portfolio last June, he has been talking to industry experts and people with first-hand experience of HIV about destigmatizing and increasing testing in immigrant communities.
“Since coming to government, I have worked with industry experts on this issue and listened to people with first-hand experience, including at the recent HIV Task Force meeting. [Health] Minister Mark Butler,” he said.
Immigration and HIV stigma
His remarks were welcomed by families who have directly encountered the barriers faced by HIV-positive people seeking permanent residency.
“I welcome the Minister’s recognition,” said Ellie Osei, who became a permanent resident in March this year.
“I think this will be a huge stress for many others who have not yet gone through what we have gone through. It has never been an easy road. We felt that we were not treated as human beings. We were just treated as numbers,” she said.
Ellie Osei (not her real name) requested anonymity out of concern for stigma in the cultural community and in the workplace.
Born in sub-Saharan Africa, she came to Australia in 2009 to work as a registered nurse in a regional Australian hospital, working in an area of severe skills shortage.
After applying for permanent residency in 2013, it took her a decade to settle her family’s lawsuit after appearing in court.
“I hope things change so that other people don’t go through what I did through the immigration system,” Ossie said, referring to the emotional toll of living in uncertainty for herself and her children.
“I think something needs to be done to ensure that people with these health problems are treated as human beings. The epidemic itself affects you as a person in terms of the stigma associated with it. [with your visa application]. “
She said she had multiple shocks throughout the process.
In 2013, she was still trying to come to terms with being HIV-positive while applying for permanent residency. The diagnosis was made during a medical examination conducted as part of the visa application process.
“It was a shock. I never expected to receive an HIV-positive diagnosis,” she said.
Ossie’s Journey to Permanent Residency
One of her two children in her custody, a nephew who lost both parents when she was seven, also had a positive medical examination.
The diagnosis supports a decision to reject an application to require people with disabilities or health conditions to pass medical cost assessments to the Australian community.
The results of the failed application for medical reasons became known on Christmas Eve 2016.
“I felt very discriminated against. It was very shocking. At the time, I paid a lot of taxes to the government as a registered nurse, and I still do. And I was working in a remote area where there was a serious lack of skills,” said Ossie.
“I felt unwanted. [of the notification] That in itself was a blow. When he was informed of his results on December 24th, just before Christmas, he felt himself devalued. Our Christmas has been ruined. “
Ultimately, the Administrative Appeals Court ruled in favor of the family in 2021 after considering factors such as Osei and her oldest son’s ability to work and support themselves, as well as being asymptomatic while on HIV treatment.
The decision was sent to the Home Office to reconsider the application. It took more than a year for Osei to know the outcome of his permanent residency.
The first time she learned of her visa results was through the automated mailing of her Medicare card.
“I thought it was a mistake. I was about to call and say, ‘I haven’t heard anything from immigration, so I think I sent this letter to the wrong person,'” she recalls.
In a letter seen by SBS News, Home Office officials apologized for not directly informing the family of the successful visa decision.
“I’m sorry, but the grant notification [sic] It had not been issued at the time the decision was made on March 2, 2023,” the communication reads.
“We are investigating why the letter was not automatically sent to your immigration agent.”
Visa barriers for people living with HIV
Alexandra Stratigos, an attorney at the HIV/AIDS Legal Center in charge of Osei’s case, said her case was not uncommon.
“There is no legal capacity (under the Immigration Act of 1958 and the Immigration Regulations of 1994) to show that someone can bear the costs associated with their treatment if they have a health condition that does not meet the standards of health. [that includes HIV],” she said.
An alternative to overcoming the health criteria requirement is to seek a health exemption that can be applied for a limited number of visa subcategories. These include next-of-kin visas, humanitarian visas and business visas.
Stratigos said he was encouraged by the immigration minister’s remarks and hoped the remarks would serve as a signal for future action to remove barriers.
“I commend the Minister for these comments and efforts to address change,” she said.
“These laws, which have been largely the same since the 1990s and have changed very little, present significant barriers for people living with HIV to enter or stay in the country.
She called on the federal government to remove the health criteria or, failing that, introduce more subclasses of visas with health exemption options.
“A very quick solution might be to amend the threshold for significant costs so that people living with HIV can continue to get visas. For example, if the threshold for significant costs were raised to say $180,000, everyone living with HIV would be able to obtain permanent residency,” she said.
Proponents call for changes to visa rules for HIV-infected immigrants
Mr Stratigos said Australia is an outlier in its approach to the health assessment process for visa applicants with disabilities and medical conditions including HIV.
“We are out of step with comparable countries, including New Zealand,” she said.
Despite national and international anti-discrimination and disability rights legislation (the Disability Discrimination Act and the Convention on the Rights of Persons with Disabilities), Australia’s immigration regulations on health standards have been in force since the 1990s.
Warnings and waivers allow immigration policies to continue.
Stratigos said the warning, known as the Declaration of Interpretation under the International Convention on the Rights of Persons with Disabilities, was signed by Australia in 2007. He added that this was discriminatory then and will continue to be discriminatory in 2023.
“It’s unfortunate that situations like this must continue to exist for the Australian government to continue to discriminate against people with disabilities,” she said.
Recent cases requiring intervention by the Minister of Immigration to override the results of health standards policies include children with autism and separate cases involving children with autism. both in Western Australia.
Fear keeps people from getting tested
Darryl O’Donnell is CEO of Health Equity Matters, a national coalition for HIV community response.
He said temporary visa holders were hesitant to present to medical facilities for HIV testing, fearing a positive test could delay visa applications or put them at risk.
“Students and some people working temporarily in Australia will be afraid of HIV testing as it could affect their permanent residency application,” he said.
“There are problems with this system and we continue to argue with the Australian government to make it clear that anyone in Australia can be tested for HIV and that this does not prevent them from applying for permanent residency.”
According to an Australian report released by the Kirby Institute, 44 percent of the 555 recorded cases in 2022 were diagnosed more than four years later. Compared to the Australian-born population, people born abroad tend to be diagnosed later.
Dr. Skye McGregor of the Kirby Institute said this was very concerning because it means not only is community transmission going undetected, but treatment by individuals has also been delayed.
She said any barriers preventing people from getting tested must be removed.
“I think the fear of visa and permanent residency delays is real when it comes to HIV, and I think it comes down to reducing the stigma around HIV, but Australia needs to do more about visa procedures,” she said.
“We need to ensure timely and accessible testing. So this could mean things like self-testing. It could mean modifying services to make them culturally appropriate. It could also mean more funding for sexual health services that are very difficult to get an appointment with at the moment.”
https://www.sbs.com.au/news/article/australias-migration-health-rules-fail-to-meet-community-standards-minister-says/ouazwfulm Visa rules for HIV-positive people do not meet community standards, minister says
