Speech #1030006709

By contrast. the interim ruling put into effect on June 1. 1991. furthers misconceptions about HIV while failing to provide the American public with one iota of added protection from the virus. The United States has one of the highest seroprevalence rates in the world. The notion that the threat of HIV comes from outside of the United States and can be avoided through exclusion of HIV Infected immigrants and travelers is medically and epidemiologically incorrect and is a potential threat to the public health. The American public must understand that it can only protect itself from HIV infection by refraining from high risk behaviors. While the interim ruling put into effect in June has no medical or epidemiologic basis. we understand that its tenets have been defended according to the question of "public charge." the concern that allowing HIV infected immigrants to become permanent residents of the United States will have a significant economic impact. While we are not lawyers. we do understand that existing immigration law already provides for exclusion of anyone who may become a public charge. This presumably explains why other diseases. such as chronic renal failure. that are equally if not more costly. are not by themselves grounds for exclusion from this country. Given these facts. we believe that a specific exclusion for HIV infection is unwarranted. We are made further comfortable in this belief by the public health considerations mentioned above and by the knowledge that many of the immigrants in question have been living. working and paying taxes in the United States for many years. and indeed often became infected in the United States. Thus we feel confident that the immigrants in question are not some sort of "medical freeloaders." An additional area of concern to which we would like to draw your attention is that of the technical instructions provided by the Centers for Disease Control to medical personnel who examine immigrants. It has come to our attention that these instructions have. as of June. 1991. been made more stringent. In addition to assessing an immigrants present health and ability to care for him or herself. physicians are now required to give a specific assessment of an immigrants future need for health care services. As medical professionals. we must point out that such judgments must necessarily be subjective and inaccurate. Moreover. the fact that such unreasonable instructions have been developed at this time leads us to wonder whether these instructions may constitute an attempt at maintaining the exclusion of HIV infected immigrants in spite of all responsible arguments to the contrary. Certainly such instructions should not be in effect when the Public Health Service as a whole has yet to decide the exclusion issue. The medically unjustified stance this nation has taken toward HIV infected immigrants and travelers In the years since exclusion became law has been a source of great embarrassment to us in the international community. The U.S. policy is out of line with the World Health Organization which has specifically stated that the screening of international travelers cannot prevent the spread of HIV. Moreover we. the U.S. professionals confronting the HIV/AIDS pandemic. are subject to boycotts from our international peers when seeking to hold international HIV/AIDS conferences in the United States.