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Forums > Social Discussion > Interesting, yet sad, article on US HIV policies

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Pele
Pele

the henna lady
Location: WNY, USA
Member Since: 15th Dec 2000
Total posts: 6193
Posted:US HIV/AIDS immigration policy article

I found this interesting, sad, intriguing and thought provoking...and thought you might too.


Pele
Higher, higher burning fire...making music like a choir
"Oooh look! A pub!" -exclaimed after recovering from a stupid fall
"And for the decadence of art, nothing beats a roaring fire." -TMK

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Doc Lightning
Doc Lightning

HOP Mad Doctor
Location: San Francisco, CA, USA
Member Since: 28th May 2001
Total posts: 13920
Posted:I wonder why the author stays. If I were he, I would simply refuse to participate in any way in such a country.

As it happens, it adds another point to my long list of reasons why I am strongly considering moving to Spain, Australia, or even England.


-Mike )'(
Certified Mad Doctor and HoP High Priest of Nutella

"A buckuht 'n a hooze!" -Valura

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natasqi
natasqi

addict
Location: Perth
Member Since: 4th Jul 2007
Total posts: 489
Posted:YAY! Come to Aus Doc!!

This is the first I've heard of it, and I'm thinking that if I or anyone else was going to visit the US.. are there signs? Does it say on a customs form?

Does anyone ask you? because if not, and it's not policed, then I don't see the point of having it.

I'd say travelers who are in a country (lets say backpackers) are more likely to have sex than someone who is immigrating. In a time period of course...

Lets say X was single and going on a 3 month trip of the US... on average they'd have sex with... (got my room mates opinions.. ranged from 15-80) if they were a virile, sexually active, no holds barred tourist.

Thats pretty high and risky (and they might not know, they might have come straight from Thailand/somewhere).
And blood tests wouldn't show up anyway.

So, IMHO, this law can't be policed, so I don't really see the point of having it.

I understand the 'you'll cost too much to our health system' but I thought it was user pays in the US...



I've always thought the 'nice' countries to live in would be Australia, New Zealand and Canada... (Canada is on a tight leash currently as I monitor the seal clubbing)
I'm glad you think Aus is a nice country Doc! biggrin


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Rouge Dragon
Rouge Dragon

Insert Champagne Here
Location: without class distinction
Member Since: 21st Jul 2003
Total posts: 13215
Posted:ditto

Especially the part where Doc should move to Aus wink


i would have changed ***** to phallus, and claire to petey Petey

Rougie: but that's what I'm doing here
Arnwyn: what letting me adjust myself in your room?..don't you dare quote that on HoP...

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Gnor
Gnor

Carpal \'Tunnel
Location: Perth
Member Since: 31st Mar 2003
Total posts: 5814
Posted:Off topic but I was told HIV has made it into our aboriginal communities. This is going to be devastating to a race of people suffering with alcoholsim and sexual abuse.
The effect on the aboriginals and the medical system here is going to be huge. frown


Is it the Truth?
Is it Fair to all concerned?
Will it build Goodwill and Better Friendships?
Will it be Beneficial to all concerned?

Im in a lonely battle with the world with a fish to match the chip on my shoulder. Gnu in Binnu in a cnu

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natasqi
natasqi

addict
Location: Perth
Member Since: 4th Jul 2007
Total posts: 489
Posted:Yeah Gnor

They used to think the incidence was the same.. but they've found its 18 times higher in Indigenous population.
And seeing as the rate of syphilis is 242x, gonorrhoea 77x and chlamydia 16x... there's a huge problem thats about to become huger!!

Makes me, a healthcare worker who is more at risk, very wary... frown


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Birgit
Birgit

had her carpal tunnel surgery already thanks v much
Location: Edinburgh
Member Since: 27th Jan 2005
Total posts: 4145
Posted:Natasqi, where do you get those stats from? I checked the world aids day site and it says a few years ago the prevalence was about the same (http://www.worldaidsday.org.au/internet/wad/publishing.nsf/Content/stats). So unless the incidence in the indigenous population has... ummmm... increased by 20-fold within a few years, do you maybe mean 18% higher?

What do the US plan on doing then? Add a little "I have not slept with anyone with HIV recently" to the "I'm not a drug dealer or a terrorist" questionnaire? (Just wondering, since I plan to travel next year, and I'm annoyed enough at the fingerprints, there's no way anyone will get my blood).

Incidentally, does anyone know what the policy is on fingerprints that are unclear because of repeated (prescribed) needle-stabbing? Will I have to do a toeprint instead?


"vices are like genitals - most are ugly to behold, and yet we find that our own are dear to us."
(G.W. Dahlquist)

Owner of Dragosani's left half

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Stout
Stout

Pooh-Bah
Location: Canada
Member Since: 12th May 2004
Total posts: 1872
Posted:Doc, seriously, move to Vancouver.

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Gnor
Gnor

Carpal \'Tunnel
Location: Perth
Member Since: 31st Mar 2003
Total posts: 5814
Posted:Birgit I get the feeling the stats on the HIV situaition in native population is fairly new.

Nat it is really scary and should make you wary. frown


Is it the Truth?
Is it Fair to all concerned?
Will it build Goodwill and Better Friendships?
Will it be Beneficial to all concerned?

Im in a lonely battle with the world with a fish to match the chip on my shoulder. Gnu in Binnu in a cnu

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Fire_Moose
Fire_Moose

Elusive and Bearded
Location: Scottsdale, AZ
Member Since: 2nd May 2007
Total posts: 3597
Posted:Wow...reminds me of a Mitch Hedberg bit.....

"Alcoholism is the only disease people can get mad at you for...Dammit Poje, you're an alcoholic. Dammit Poje, you have Lupus. One of those just doesn't sound right."

Now we can add HIV to the list i suppose.


O.B.E.S.E.

Owned by Mynci!

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Pele
Pele

the henna lady
Location: WNY, USA
Member Since: 15th Dec 2000
Total posts: 6193
Posted:The thing that struck me was the mention of the Haitian refugees. Throw that in with the Cuban ones as well and the thing is, they are illegal.

So, our governmental idiot..er...leaders enacted an immigration and tourism policy based on illegal immigrants/refugees.
Brilliant.

Mike, his life is here. His spouse, his kids, his career. He obviously has strong ties.

I've thought and wanted so many times to leave the US but Noah and his stability keeps me here. It's a good place to be a kid but a sucky place to be an adult, me thinks.

I also completely agree with you natasqi. I've known many a wanderer who did not have high levels of discretion.
It's so outdated and slanted.

Birgit, all I can say is good luck. I have no idea.


Pele
Higher, higher burning fire...making music like a choir
"Oooh look! A pub!" -exclaimed after recovering from a stupid fall
"And for the decadence of art, nothing beats a roaring fire." -TMK

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Birgit
Birgit

had her carpal tunnel surgery already thanks v much
Location: Edinburgh
Member Since: 27th Jan 2005
Total posts: 4145
Posted:Well, I AM going to Mardi Gras and the gay ball and to see Molly and NYC and the Keys and maybe revisit San Francisco. If they don't like my fingerprints I can always use these.
http://www.presstv.ir/Detail.aspx?id=49758&sectionid=351020604

Natasqi, do you have a reference? I'd be interested in looking it up smile I mean, I'm not saying you're talking out of your bum or anything, just surprised how the stats would change so quickly in so little time! As a half-medic (pharmacologist/toxicologist) that kind of stuff intrigues me smile


"vices are like genitals - most are ugly to behold, and yet we find that our own are dear to us."
(G.W. Dahlquist)

Owner of Dragosani's left half

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natasqi
natasqi

addict
Location: Perth
Member Since: 4th Jul 2007
Total posts: 489
Posted:Sorry you had to ask twice :P But I do need to sleep sometimes! :P

"Until now, the prevalence of HIV in the Indigenous community has been considered similar to that in the non-Indigenous community.1 In this issue of the Journal (page 124), Wright et al present evidence of a higher rate of HIV among Indigenous people in Western Australia than in the non-Indigenous population.2 They report that, while the rate of HIV notifications in the non-Indigenous population declined between 1985 and 2002, it increased in the Indigenous population. The difference in risk for Indigenous women was striking 39% of all female HIV notifications in WA since 1994 have been for Indigenous women, giving an Indigenous : non-Indigenous age-standardised rate ratio of 18. In contrast, the rate ratio for Indigenous males was 2. Wright et al also confirmed the marked differentials in risk of other sexually transmitted infections (STIs) in the Indigenous population with Indigenous : non-Indigenous age-standardised rate ratios of 242 for syphilis, 77 for gonorrhoea and 16 for chlamydia. The data in this study are likely to predominantly reflect the situation in rural and remote regions of WA, and the authors acknowledge the difficulties of interpreting surveillance data. Nevertheless, the findings demand attention."

<b>giving an Indigenous : non-Indigenous age-standardised rate ratio of 18.</b>
rate RATIO means 18x right, not 18% higher... I'm PRETTY sure.. but then again I wagged all my statistics lectures...

From an eMJ article, Controlling HIV in Indigenous Australians http://www.mja.com.au/public/issues/183_03_010805/bow10590_fm.html


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natasqi
natasqi

addict
Location: Perth
Member Since: 4th Jul 2007
Total posts: 489
Posted:and this one..

"The annual number of HIV diagnoses among Indigenous people was relatively stable, but among non-Indigenous people it declined steadily over time."

HIV and AIDS in aboriginal and Torres Strait Islander Australians: 1992-1998. The National HIV Surveillance Committee.
http://www.ncbi.nlm.nih.gov/pubmed/10860091


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natasqi
natasqi

addict
Location: Perth
Member Since: 4th Jul 2007
Total posts: 489
Posted:Aaah, just read the article properly... 18x for females, 2 times for males.. Sorry for mucking up that :P

So basically same for guys, 18 times for females.

Still worrying.


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Birgit
Birgit

had her carpal tunnel surgery already thanks v much
Location: Edinburgh
Member Since: 27th Jan 2005
Total posts: 4145
Posted:Sorry, I thought since you'd written something in between you might've overlooked it hug

It's worrying indeed, and I wonder if the stats I read about 2005 were wrong then. Also indicates that there are different mechanisms of transmission, like higher rate of heterosexual transmission.

Semi-ignorant question - could it be so different because they were looking at WA, or is the percentage of Indigeneous Australians similar in every state?


"vices are like genitals - most are ugly to behold, and yet we find that our own are dear to us."
(G.W. Dahlquist)

Owner of Dragosani's left half

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fanged_angel
fanged_angel

poiromaniac
Location: liverpool, uk
Member Since: 11th Jul 2007
Total posts: 162
Posted: Written by :Doc Lightning


or even England.



whats so bad about england? sure the weather is crappy, petrol is like twenty times the price, any form of technology gets here months after the US and its full of chavs but it does have its charms biggrin


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Gnor
Gnor

Carpal \'Tunnel
Location: Perth
Member Since: 31st Mar 2003
Total posts: 5814
Posted: Written by

HIV and AIDS in aboriginal and Torres Strait Islander Australians: 1992-1998.



Whats the rate now Natsqi. Thats 10 years ago....I think it would be worse now frown


Is it the Truth?
Is it Fair to all concerned?
Will it build Goodwill and Better Friendships?
Will it be Beneficial to all concerned?

Im in a lonely battle with the world with a fish to match the chip on my shoulder. Gnu in Binnu in a cnu

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Mr Majestik
Mr Majestik

coming to a country near you
Location: home of the tiney toothy bear
Member Since: 9th Mar 2004
Total posts: 4693
Posted:diabetes is also really harsh on aboriginals and islanders, mainly because of the high sugar diet of western society that their bodies aren't used to.

"but have you considered there is more to life than your eyelids?"

jointly owned by Fire_Spinning_Angel and Blu_Valley

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Pele
Pele

the henna lady
Location: WNY, USA
Member Since: 15th Dec 2000
Total posts: 6193
Posted: Written by :Mr Majestik


diabetes is also really harsh on aboriginals and islanders, mainly because of the high sugar diet of western society that their bodies aren't used to.



And with the Native's here, alcoholism and their diabetes tend to play into making things worse.

I saw something on television about helping AIDS in Africa, and all I could think is what a load. Help them *in* Africa, so long as they stay on the other side of the border.

I did forget to mention that in Haiti at the US refugee "camp" (prison) where the Cubans and Haitians are sent (their countries won't take them back and they can't come into the US soooo they get sent there) will cut themselves and attack the guards. The guards (US soldiers) have to wear special suits, that equate to being large condoms, to protect themselves from this.
That is how desperate these people are.
Two high school friends of mine were stationed there years ago, before they were shipped to Iraq in Desert Storm. They both said the fishing was awesome, everything else sucked. They also under went AIDS testing monthly.
Makes me wonder if they had have been infected what would the gov't have done. Sent a really nice apology note to their families?


Pele
Higher, higher burning fire...making music like a choir
"Oooh look! A pub!" -exclaimed after recovering from a stupid fall
"And for the decadence of art, nothing beats a roaring fire." -TMK

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natasqi
natasqi

addict
Location: Perth
Member Since: 4th Jul 2007
Total posts: 489
Posted:I tried looking for new stats, but can't find them. The first article is 2005. Australian Bureau of Stats didn't help sorry...

 Written by :Pele


And with the Native's here, alcoholism and their diabetes tend to play into making things worse.





Is 'Natives' PC in the US?
I know Australia's gone through a lot of changes. I don't think Aborginals can be used... you can describe someone as as Aboriginal, but 'Aboriginals' or 'Aborigines' isn't...
Indigenous Australians is what I have to say in all my case reports.

So, how about the US?


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Doc Lightning
Doc Lightning

HOP Mad Doctor
Location: San Francisco, CA, USA
Member Since: 28th May 2001
Total posts: 13920
Posted:The PC term in the U.S. is Native American. But then again, I've had a few tell me that they prefer to be called "Indians."

shrug


-Mike )'(
Certified Mad Doctor and HoP High Priest of Nutella

"A buckuht 'n a hooze!" -Valura

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Pele
Pele

the henna lady
Location: WNY, USA
Member Since: 15th Dec 2000
Total posts: 6193
Posted: Written by :Doc Lightning


The PC term in the U.S. is Native American. But then again, I've had a few tell me that they prefer to be called "Indians."

shrug




Going along with what Doc said natasqi most that are around here (we have *alot* of reservations/historic areas in WNY) prefer to be called by their tribe or nation affiliation.
Many of the ones I know agree that Indian is fine, as is Native American, when making a blanket statement.

I can say they *hate* when tourists come over and go to their casinos or the museum in Niagara Falls and call them "Red Indians", which I actually heard used when I was in Ireland.


Pele
Higher, higher burning fire...making music like a choir
"Oooh look! A pub!" -exclaimed after recovering from a stupid fall
"And for the decadence of art, nothing beats a roaring fire." -TMK

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natasqi
natasqi

addict
Location: Perth
Member Since: 4th Jul 2007
Total posts: 489
Posted:Where does 'Red Indians' come from then?

(I know nothing about American history so this is interesting)


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willworkforfoodjnr
willworkforfoodjnr

Hunting robot foxes
Location: Huddersfield, West Yorkshire
Member Since: 8th Aug 2007
Total posts: 1046
Posted:Columbus and his possie were trying to get around the world to India, when they landed on the eastern shore of America they thought they'd found it. Thus when they met the red-skinned natives they called them the Red Indians, and the name stuck even after they realised the mistake.

Working hard to be a wandering hippie layabout. Ten years down, five to go!

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Pele
Pele

the henna lady
Location: WNY, USA
Member Since: 15th Dec 2000
Total posts: 6193
Posted:Actually, they thought they were in India, they called them Indians.

It wasn't until after the Spanish and French joined in that they called them "Red Indians".


Pele
Higher, higher burning fire...making music like a choir
"Oooh look! A pub!" -exclaimed after recovering from a stupid fall
"And for the decadence of art, nothing beats a roaring fire." -TMK

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Eera
old hand
Location: In a test pit, Mackay
Member Since: 29th May 2003
Total posts: 1107
Posted:I wouldn't be holding Australia up as a bastion of greatness when it comes to refusing to admit people with various disease; I don't know whether it's a blanket ban or discretionary, but anything that might cost Medicare will exclude you from immigration here too.

You have X rays when you apply, any sign of TB, tough luck until you get it sorted. I read an article about an English doctor who was about to emigrate here - until they found out he had a disabled daughter who required extensive hospitalisation - his visa was revoked. I have a friend whose husband has quite serious Crohns disease, although she's in a high demand industry and can easily find corporate sponsorship, she is being put on the "we'll call you if a vacancy comes up" list, in other words she's excluded.

Check out Form 1071i "Health Requirements For Permanant Entry to Australia" from the immigration website. "only TB is mentioned in migration legislation as precluding the issue of a visa", however, the list of other things which can also be used are Hepatitus, HIV/AIDS and obesity-related problems. They're very upfront about saying that you will not gain entry if you are going to cost us anything, prove a risk to public health or prevent an Australian resident from accessing the health system that you are going to tie up.


There is a slight possibility that I am not actually right all of the time.

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Pele
Pele

the henna lady
Location: WNY, USA
Member Since: 15th Dec 2000
Total posts: 6193
Posted:"Obesity-related problems" ???

Wow.
Yup..I think that trumps the U.S. AIDS ban wink


Pele
Higher, higher burning fire...making music like a choir
"Oooh look! A pub!" -exclaimed after recovering from a stupid fall
"And for the decadence of art, nothing beats a roaring fire." -TMK

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natasqi
natasqi

addict
Location: Perth
Member Since: 4th Jul 2007
Total posts: 489
Posted: Written by :Eera


I wouldn't be holding Australia up as a bastion of greatness when it comes to refusing to admit people with various disease;



Haha, I don't believe anyone was.. I just think it's a 'nice' country. Maybe I should say better.. *shrugs* I don't want to get into a patriotic slur contests :P

TB is the only thing they look for (or it says they look for) on visiting rights. So people with HIV aren't banned from entering Australia...



Interestingly, my other 'nice' countries...
New Zealand will refuse to allow residency for those who
"requires dialysis treatment, or
has pulmonary tuberculosis (TB), or
has severe haemophilia, or
has a physical incapacity that requires full-time care"
* HIV infection
* Hepatitis B surface antigen positive, with abnormal liver function
* Hepatitis C, RNA positive, with abnormal liver function
* Malignancies of solid organs and haematopoietic tissue, including past history of, or currently under treatment
Exceptions are:
1. treated minor skin malignancies (not melanoma)
2. malignancies where the interval since treatment is such that the probability of cure is > 90%, e.g.: early stage (I & IIA) breast cancer at 5 years; low risk prostate cancer at 5 years; early stage (Dukes A & B1) colorectal cancer at 5 years; childhood leukaemia at 5 years

* Solid organ transplants, excluding corneal grafts more than 6 months old
* Chronic renal failure or progressive renal disorders
* Diseases or disorders such as osteoarthritis with a high probability of arthroplasty in the next four years
* Central Nervous System disease, including motor neurone disease, complex partial seizures, poorly controlled epilepsy, prion disease, Alzheimer's and other dementia, and including paraplegia and quadriplegia
* Cardiac disease including ischaemic heart disease, cardiomyopathy or valve disease requiring surgical and/or other procedural intervention
* Chronic obstructive respiratory disease with limited exercise tolerance and requiring oxygen
* Genetic or congenital disorders: muscular dystrophies, cystic fibrosis, thalassaemia major, sickle cell anaemia if more than one sickle crisis in 4 years, severe haemophilia, and severe primary immunodeficiencies
* Severe autoimmune disease, currently being treated with immuno-suppressants other than prednisone
* In a person up to the age of 21 years, a severe (71-90 decibels) hearing loss or profound bilateral sensori-neural hearing loss
* In a person up to the age of 21 years, a severe vision impairment with visual acuity of 6/36 or beyond after best possible correction, or a loss restricting the field of vision to 15-20 degrees
* In a person up to the age of 21 years, a severe physical disability, where they are unable to stand and walk without support, and cannot independently dress, eat, hold a cup, or maintain their stability when sitting.


Canada

Can't find a specific list of conditions but mentions the same old
" * Danger of contagion;
* Unpredictable or unusual behaviour that may create a danger to public safety; and
* The supply of social or health services that the person may require in Canada and whether the use of such services will deprive Canadian nationals of these services.

US
has been very hard to find.. no big lists either, only
1/ except as provided in subparagraph (C) 1a/ who seeks admission as an immigrant, or who seeks adjustment of status to the status of an alien lawfully admitted for permanent residence, and who has failed to present documentation of having received vaccination against vaccine-preventable diseases, which shall include at least the following diseases: mumps, measles, rubella, polio, tetanus and diphtheria toxoids, pertussis, influenza type B and hepatitis B, and any other vaccinations against vaccine-preventable diseases recommended by the Advisory Comm ittee for Immunization Practices,

(iii) who is determined (in accordance with regulations prescribed by the Secretary of Health and Human Services in consultation with the Attorney General)-

(I) to have a physical or mental disorder and behavior associated with the disorder that may pose, or has posed, a threat to the property, safety, or welfare of the alien or others, or

(II) to have had a physical or mental disorder and a history of behavior associated with the disorder, which behavior has posed a threat to the property, safety, or welfare of the alien or others and which behavior is likely to recur or to lead to other harmful behavior, or

(iv) who is determined (in accordance with regulations prescribed by the Secretary of Health and Human Services) to be a drug abuser or addict, is inadmissible.

So America doesn't say anything about "you can't come in if it will cost us money' I guess...
So I'm guess HIV for them is the infectious side and not the transmission side.


Obesity is easy to understand. Basically if someone is obese (in a doctors eyes), they also have/will get, diabetes, hypertension, osteoarthritis, heart disease, sleep apnoea, hormone and fertility problems, fungal skin problems, mobility problems...

The HIV people may need very expensive drugs... but all the surgeries and medications for obese people.. well it'ld be too long to make the calculations.. but they might be comparable.

So if we're gonna say "you can't come in if you're gonna cost us money" then obesity would be a good one to exclude.


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Birgit
Birgit

had her carpal tunnel surgery already thanks v much
Location: Edinburgh
Member Since: 27th Jan 2005
Total posts: 4145
Posted:"Basically if someone is obese (in a doctors eyes), they also have/will get, diabetes, hypertension, osteoarthritis, heart disease, sleep apnoea, hormone and fertility problems, fungal skin problems, mobility problems..." - that's harsh. "can get"/"may get" etc would be ok, but saying that all obese people have or will get all of these is really going a step too far. I know you're a medic and you have seen all of these, I for one have yet to see how all obese people have or will get fungal skin problems for example shrug

I guess I'd be happier if they said "you can immigrate if you can prove you can provide for private health insurance" - keeping out people with hearing impairments for example seems pretty harsh to me. They probably cost less than a lot of the people they don't exclude, and you don't need a new hearing aid prescribed every 2 weeks anyway.


"vices are like genitals - most are ugly to behold, and yet we find that our own are dear to us."
(G.W. Dahlquist)

Owner of Dragosani's left half

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natasqi
natasqi

addict
Location: Perth
Member Since: 4th Jul 2007
Total posts: 489
Posted:smile No, not everyone who is obese will get all these complications... it was and/or. the ellipse was meant to signify it was a list, sorry smile

It was my way of saying, people with obesity are a ticking time-bomb. And it is HIGHLY likely that they will cost the health system a lot of money.

This isn't the obesity discussion thread, so I won't talk about it here anymore...

I don't think you can force people to get health insurance... excluding people because of inability to buy insurance is then letting in the rich and ignoring the poor...

And the hearing impairments are for under 21s. So I'm guessing this is because children with hearing impairments need to go to special schools and have community health nurses and speech pathologists and other specialists to help them, not just the hearing aid.

Like the visual impairments... I have worse than 6/36 vision, but it is correctable. If it wasn't, I'd have to have modifications for my home, which the government subsidises. I'd get special schooling, and respite camps, and braille computer keyboards etc etc.

I think that keeping people out of countries for reasons other than protecting the current population from infection is morally suss. But then I support global communities, not national ones.


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