• Open Access

Australian migration policy of HIV-infected individuals requires renewed discussions

Authors


Correspondence to:
Dr David Wilson, Faculty of Medicine, University of New South Wales, Level 2, 376 Victoria Street, Darlinghurst, New South Wales 2010. Fax: (02) 9385 0920; e-mail: dp.wilson@unsw.edu.au

The Prime Minister of Australia, John Howard, has recently presented his view that HIV-infected individuals should be denied entry to live in Australia as migrants or refugees.1 All hopeful migrants are tested for HIV and Australia already has strict immigration rules for those determined to be infected with the virus. The main issue for the Department of Immigration and Multicultural and Indigenous Affairs is whether there will be ‘undue cost’ to the Australian community.2 Howard's position is based on current criteria that apply to people with tuberculosis (TB). Howard also alluded to the public health implications of the epidemics and eliminating entry of infected individuals would reduce transmission. While this is true, clearly active TB is a respiratory infection that is easily transmissible, whereas HIV can only be transmitted by direct contact with bodily fluids containing the virus. However, HIV at present is a life-long disease and does not become ‘latent’ or ‘effectively’ treated like TB;3,4 and if HIV is treated, the risk of transmission is reduced significantly.5–7 For individuals with evidence of active TB, a treatment course (over approximately six months) is required before potential migration to Australia. If the Australian health system would be contributing to the life-long treatment of HIV with antiretroviral therapies (ART), an undue cost burden could actually be realised. It must be noted, though, that in recent years ART regimes against HIV have decreased drastically in cost, but the immigration policies surrounding HIV-infected individuals have not been updated. It would be worthwhile to conduct a new series of discussions surrounding this issue, based on the latest public health and medical information available.

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