Immigrating to Canada can be exciting. It can be traumatic. And it can be both at the same time. Coming to Canada can be difficult. It can mean leaving family. Living with a new language. Being surrounded by culture and customs that are unfamiliar.
As many service providers already know, women living with HIV often face unnecessary barriers when they try to enter countries as visitors, immigrants or refugees. Governments argue that these policies protect both citizens’ health and a country’s finances by barring people with the virus from coming in. This is often just another form of HIV discrimination.
The United Nations has stated that “there is no public health rationale for restricting liberty of movement or choice of residence on the grounds of HIV status.” 1
Where people living with HIV face persecution in their countries of origin, or where they seek to be reunited with family members, humanitarian concerns and international law should and often do push countries with such barriers to lift them and welcome people living with HIV.
Canada, Immigration Medical Examinations and HIV
In general, Canadian legislation requires that immigrants, permanent resident applicants and temporary residency applicants have a mandatory Immigration Medical Examination (IME). This exam is done by a medical practitioner designated by Citizenship and Immigration Canada.
(Permanent resident applicants include refugees.)
Many newcomers and immigrant women find out about their HIV-positive status as the result of an IME. A woman can learn her status in her home country, where she might not have adequate supports.
Temporary residency applicants include students and temporary workers. Depending on the length of stay and the regulations of the province that an applicant wants to visit, an IME might not be required.
Under Canadian law and policy, HIV-positive people are not barred from entering the country. However, the Act does mention that people may be deemed medically inadmissible.
What does this mean? An applicant who is considered a possible danger to public health or safety will not be allowed in Canada. As well, a person who needs a lot of support from social and health services might be medically inadmissible because of the anticipated costs for those services.
Temporary stays in Canada
The Immigration and Refugee Protection Act does not bar people with HIV who apply to enter the country temporarily:
- for six months or less
- as students
- as workers
- as visitors
Applicants for short stays – six months or less – are generally not eligible for provincial government medical insurance coverage. Only in rare circumstances are such applicants denied entry. Severe illness that requires hospitalization is one reason an application might be turned down.
Temporary resident applicants who want to stay in Canada for periods longer than six months get individual assessments and will most likely require an Immigration Medical Examination (IME) as part of their assessment process.
Demands on social and health services are considered because – depending on the policies of province they are living in – temporary residents may be eligible for social and health benefits. In Ontario, temporary residents are eligible for health coverage under OHIP.
Applicants do not need to disclose:
- their HIV status
- their use of anti-retroviral (anti-HIV) medications
Still, a visa officer can always request an IME. This includes an HIV test. – See more at: http://shexchange.net/wp/essentials/immigration#sthash.ZY8Tt6pc.dpuf
Refugee applicants to Canada must have an Immigration Medical Examination (IME) done in Canada, which includes an HIV test. However, a positive HIV test result will not determine eligibility to enter Canada.
Refugee status has nothing to do with a person’s use of social and health services.
When a refugee claim is deemed eligible to the Immigration and Refugee Board, health services are covered under the Interim Federal Health Program. This program provides temporary health insurance to refugees, refugee claimants, protected persons and their dependents.
As a result, HIV-positive refugee women do not have to pay for medical treatment and anti-retroviral (anti-HIV) medication.
Women applying for permanent residency who are sponsored by family members are required to have an IME, including an HIV test. – See more at: http://shexchange.net/wp/essentials/immigration#sthash.ZY8Tt6pc.dpuf
- An HIV-positive test result will not mean people are denied entry to Canada if they are the partners – including common-law – or dependent children of Canadian citizens or permanent residents. The application will not be reviewed under the excessive demands provision of the Immigration and Refugee Protection Act.
- For women who apply under the family class as a mother or sister, the exceeding demand provisions of the Immigration and Refugee Protection Act can affect their applications. They could be denied based on an HIV-positive test result – viewed as medically inadmissible because of the belief that they will place too many demands on health services.
Service providers know that women might live in emotional, financial and physically abusive relationships after being sponsored to come to Canada. Adding HIV to the mix can complicate things even further.
The culture shock of moving to a new country – language barriers, isolation from loved ones, lack of financial stability and the fear of being deported – can mean that many women remain in abusive situations.
Their partners might:
- cancel sponsorship
- reveal their positive status to relatives or community members
- deny them access to social service agencies – even ESL classes
- take children away
Even the threat to do any of these things can easily lead to social isolation, complete dependency and an endless cycle of abuse.
For more information go to: Canada’s immigration policy as it affects people living with HIV , updated May 2013 , Canadian HIV/ AIDS Legal Network
1 Immigration and Travel, Canadian HIV/AIDS Legal Network, website text as of June 2011