Being HIV positive is no longer a death sentence. So why does Canada insist on sharing immigration applicants’ HIV status with their sponsors?

Of note:

When they found love in Mexico 10 years ago, one of the first things the Canadian man’s boyfriend confided in him was that he was HIV-positive.

But the medical condition was no longer seen as the health threat it had once been, and it wasn’t going to stop their budding relationship.

The couple maintained a long-distance romance for four years before the Mexican partner moved to Toronto in 2017 on a work permit.

It was when they started their spousal sponsorship application in 2020 that the couple learned of Canada’s automatic HIV-partner-disclosure policy.

It’s a policy that mandates an immigration applicant or refugee prove they have disclosed their medical condition to the person who is sponsoring them to Canada.

The couple say they found the formal process not only offensive but frustrating, as it delayed the processing of their file for an additional 18 months.

Finally, they were scheduled for the long-awaited brief interview in April to confirm, in person, that the sponsored partner’s HIV status had been disclosed.

“It’s not just a privacy issue. I also just feel incredibly stigmatized,” said the 55-year-old Canadian fashion designer, who asked not to be identified to protect his partner’s privacy.

“I don’t feel it’s anybody’s business, and I don’t feel it’s something that needs to be addressed for my partner.”

The so-called “automatic partner notification policy” has been in place since 2003 as a public health measure to stop the spread of the HIV virus, which, if untreated, can lead to acquired immunodeficiency syndrome or AIDS, a disease that has killed millions.

However, modern medical treatment has transformed the virus into a manageable medical condition, and advocates say that, after two decades, the immigration department’s “out-of-date and discriminatory” policy should go.

In mid-June, three organizations wrote to Immigration Minister Sean Fraser and Marci Ien, the minister for women and gender equality and youth, demanding the policy be revoked and saying that it was discriminating against people with HIV and violating their right to equal treatment under the Canadian Charter.

“Not only does the Policy significantly extend the length of processing of immigration applications for people living with HIV, it also perpetuates myths and stereotypes that people with HIV are deceptive and are less worthy of intimate relationships,” the letter noted.

The signatories of the letter include the HIV & AIDS Legal Clinic of Ontario (HALCO), the HIV Legal Network, and the Coalition des organismes communautaires québécois de lutte contre le sida (COCQ-SIDA).

Michael Battista, their counsel, said the policy is discriminatory because only those applicants sponsored under the family and refugee classes are subject to the disclosure to partner policy.

Temporary residence visa applicants — visitors, international students, temporary foreign workers — and those applying for permanent residence under economic class are not under the same scrutiny even though they, too, could potentially be HIV positive.

“We let in HIV-positive foreign students, foreign workers. We don’t ever force them to reveal to their intimate partners that they’re HIV positive. Why are we singling out the family class and dependent refugees?” asked Battista.

“It’s not even serving the ends of its public health concern.”

The policy is unique to HIV-positive applicants. There is no similar mechanism for other health conditions.

Immigration applicants with active pulmonary tuberculosis (TB) and untreated syphilis can be found inadmissible to Canada, unless they are treated, on the grounds that their condition is a danger to public safety, according to the standards laid down by Health Canada.

However, unlike TB and untreated syphilis, immigration officials do not consider HIV a danger to public health.

When the original policy was implemented, it required consent of the HIV-positive applicant for immigration officials to contact their sponsor in Canada about their HIV status and assess whether the sponsor would withdraw their application.

To avoid the impression that the policy was prompting sponsors to withdraw their applications, the updated policy has, since 2016, given the HIV-positive applicant 60 days to provide proof they have informed their sponsor of their diagnosis or to withdraw their application. If the applicant takes no action, immigration officials will then inform the sponsor about their HIV status after 60 days have elapsed.

HIV-positive sponsorship applicants must also attend a compulsory interview that is not required of other sponsorship applicants.

Battista said immigration officials had not strictly adhered to the policy until about 18 months ago, when he started to see the processing times of the HIV positive clients’ cases “inexplicably lengthened.”

“The explanation we got was they were being put into the interview stream automatically. We tried to be proactive and provide evidence that the sponsor was advised of the HIV-positive health condition of the person being sponsored,” said Battista. “But they just didn’t budge.”

He said the policy perpetuates a stereotype that people with HIV are morally blameworthy and irresponsible in taking precautions to prevent the transmission of HIV.

On its website, the immigration department said the policy does not intend to “inflict unnecessary hardship” on applicants or sponsors.

“Rather, it is a measure that will protect the health and safety of the spouses and partners (residing in Canada) of applicants in the family and dependent refugee classes who test positive for HIV,” it noted.

While the change of language in the 2016 policy was an improvement, Avineet Cheema, staff lawyer at HALCO, said it still doesn’t reflect modern science.

“This is a policy that was implemented at a time when there wasn’t as much modern science advancements when it comes to HIV and suppressing viral loads and things like that,” said Cheema, who has seen cases in which an officer asked the sponsor why they’re comfortable marrying an HIV carrier.

“Being diagnosed with HIV is in no way a death sentence at this time. And it is very manageable with medications to the point that there isn’t even a real decrease in life expectancy.”

There are other sexually transmitted infections, said Cheema, and singling out HIV further stigmatizes those living with the virus.

“That really targets the dignity of people who are living with HIV, because the Canadian government is essentially telling them, ‘You’re different. You are dangerous. Your health condition makes it so.’”

The policy, she added, disproportionately affects gay, trans, Black and other racialized people, due to the heightened impact of the HIV stigma.

The Canadian sponsor of the Mexican partner said they are committed and responsible adults, but were uncomfortable at their April interview at the immigration office in Niagara Falls.

“I felt there was homophobia hidden behind a mask of protocol,” he said. “I don’t think it’s fair that they single out people with HIV. It’s not fair for my partner to have to go through that.”

In an email to the Star, the immigration department said it doesn’t collect data on the notifications issued, interviews conducted and sponsorship withdrawals recorded under the policy.

A department spokesperson said the policy is currently under review and that any modifications will be made to the public when it is completed.

Source: Being HIV positive is no longer a death sentence. So why does Canada insist on sharing immigration applicants’ HIV status with their sponsors?

‘An issue that pulls at the heartstrings’: MPs review rules that reject immigrants on medical grounds

Will be interesting to see where CIMM sees an appropriate balance between compassion and cost:

Members of Parliament begin a review today of rules that reject immigrants because they could be a drain on Canada’s social services and health-care system.

As it stands, applicants can be refused if their condition is a potential danger to public health or safety, or if immigration officers believe they could cause “excessive demand” on the system.

Determinations are based on whether anticipated costs are expected to exceed the average Canadian per-capita health or social services costs over a five-year period, or if they could add to an existing waiting list that might delay care for Canadian citizens or permanent residents.

Liberal MP and immigration committee chair Rob Oliphant said the government has signalled interest in the issue in the wake of high-profile cases, including the one of a York University professor whose application for permanent residency was turned down because his son has Down syndrome.

“If these are mostly economic migrants coming in and making money and paying taxes, is there really a net benefit, or is it a net cost? We don’t know and we want to find out,” he said.

Figures provided to CBC News from Immigration, Refugees and Citizenship Canada show a sharp decline in the number of applications rejected on medical grounds in the last three years. In 2016, 337 applicants were deemed inadmissible, down from 473 in 2015 and 619 in 2014.

Conservative immigration critic Michelle Rempel said the longstanding federal policy has attempted to strike a difficult balance.

“It’s an issue that pulls at the heartstrings, because there are many cases of people who come to Canada with dire medical needs who will be found to be medically inadmissible,” she said. “It brings out the compassionate care of Canadians.”

Rempel wants to hear from witnesses on whether the policy is being applied adequately and consistently, and what the impact of any potential change could be on overall costs and waits for services for Canadians.

Ability to pay not a factor

According to the rules around medical inadmissibility, a willingness or ability to pay is not a factor for services that are publicly funded like physician or hospital care, since there is no cost-recovery regime in place.

However, it is a consideration in assessing an applicant who has financial means to defray costs of medication or services that are not publicly funded, such as HIV antiretroviral therapy.

Ottawa-based immigration lawyer Ronalee Carey called the policy “two-faced” because it allows a discrimination against immigrants that would never be permitted against Canadians with intellectual or physical disabilities.

She said the estimated health costs of these potential immigrants is a small fraction of the total cost of the country’s health-care system, and that the policy ignores other contributions the newcomers could make to society.

More than money

“It’s more than just money and economics,” she said. “It’s a political decision and that’s why we elect officials, but I would really ask them to look at what these people bring to us beyond a health-care problem. What does the entire family bring?”

Identified public health and safety issues range from active pulmonary tuberculosis and untreated syphilis to mental health issues such as pedophilia, sociopathic behaviour disorders or paranoid states or substance abuse that can lead to violent, hostile or disruptive behaviour.

The immigration committee begins its study this morning, hearing from officials in the immigration department. MPs will also hear from legal and economic experts and advocacy groups.

Source: ‘An issue that pulls at the heartstrings’: MPs review rules that reject immigrants on medical grounds – Politics – CBC News