New Zealand: HIV no longer blocks residency in New Zealand, but mandatory testing stays

Immigration removes HIV from list of high cost conditions

HIV is no longer considered a high cost condition following a policy review by the Immigration Minister. However, NZ is still among just 18 countries that will require migrants to get an HIV test for a visa or residence.

HIV infection has been removed from Immigration New Zealand’s list of medical conditions deemed likely to impose significant costs or demands on New Zealand’s health services after a review.

Immigration NZ has a list of more than 40 medical conditions, including HIV, deemed to impose “significant costs” on the public health system and/or education services.

Migrants seeking to apply for a work to residence visa have to complete a character test, which includes a police check, as well as a medical check known as the Acceptable Standard of Health (Ash) test.

New Zealand’s publicly-funded health services are tax-funded and provide universal coverage for citizens, residents, and people on work visas staying for more than two years.

An Immigration NZ medical assessor determines whether the applicant is unlikely to impose significant costs on health services to pass the medical test. If applicants don’t meet the Ash requirements then they can seek a medical waiver.

For more than a decade, Immigration NZ has kept the threshold of “significant costs” at $41,000 per year within a period of five years from the date the assessment against health requirements is made or a lifetime if it is a chronic condition.

After years of advocacy, Immigration NZ has decided to remove HIV infection from the list.

However, New Zealand will continue to require HIV testing as a requirement for visa applicants intending to stay for more than 12 months, along with all other existing examination and test requirements.

INZ policy integration director Nick Aldous says the decision to remove HIV infection from Immigration NZ’s list of high-cost health conditions is because it is now considered to be a manageable chronic illness, and treatment costs are no longer considered significant.

However, Aldous says the continued testing requirement for visa applicants intending to stay in the country for more than a year is because HIV is still considered a serious chronic illness and can present a risk to public health given it’s easily spread through unprotected sexual contact and sharing contaminated needles.

The change came into effect on October 15.

According to the United Nations AIDS Still Not Welcome report published in 2019, 203 countries, territories and areas did not have any HIV-related restrictions on entry, stay and residence.

“We are so glad that the tireless mahi over many years has resulted in this step towards dismantling HIV stigma at an immigration level and has brought our country’s policies closer in line with the latest scientific and public health recommendations. It’s a proud moment.”
– Jason Myers, New Zealand AIDS Foundation

New Zealand is among 18 countries that still did, including Australia and Israel.

In a letter to the New Zealand AIDS Foundation, Immigration NZ chief medical officer Rob Kofoed said the removal of HIV infection from the list meant the individual health circumstances of each visa applicant with the condition could be assessed on a case by case basis.

INZ was previously obliged to determine that a resident visa applicant with HIV did not have an acceptable standard of health.

​​New Zealand AIDS Foundation chief executive Jason Myers said the decision came as a relief.

With appropriate treatment, he said, people living with HIV who maintained undetectable viral load do not transmit the virus through sexual contact, and treating HIV here no longer poses significant costs on the public health budget.

“We are so glad that the tireless mahi over many years has resulted in this step towards dismantling HIV stigma at an immigration level and has brought our country’s policies closer in line with the latest scientific and public health recommendations. It’s a proud moment.”

Myers did not comment on the requirement for testing still being part of the visa and residence process.

An Indian migrant, who did not want to be named, told Newsroom he is relieved by the news.

The man who was tested positive for HIV last year says INZ’s policy added to the anxiety and uncertainty he felt when he first learnt of his diagnosis.

“There is still a lot of stigma attached to it back home. I had many sleepless nights. I didn’t know how to tell my family back home, or work,” he says.

“I contacted lawyers last year who told me it is going to be really hard to apply for residency because it’s not up to acceptable health standards.”

But the man says removing the condition from the high cost list was “life changing” for him.

“I feel like the battle is finally over. No more having to convince immigration and the Ministry of Health. I think it’s a celebration for migrants.”

But he says INZ should do away with the ongoing requirement of testing for HIV, as it has removed it from the list of medical conditions.

“It’s irrelevant. If they’re removing it from the list, then why would you want to do the test? That’s not clear to me.”

Green Party MP Ricardo Menéndez March is seeking a full review of the “ableist” medical requirements from Immigration Minister Kris Faafoi.

Menéndez March said ideally the list should be removed from the health criteria qualifying residency, saying he was disappointed that migrants would still be required to undertake HIV tests for visas.

“For too long the Government has stigmatised migrants living with HIV and prevented them from being able to obtain visas on the basis of their diagnosis.

“Mandatory HIV testing for migrants only compounds to the existing stigma and the Ministry of Health released a report making it clear HIV testing should remain voluntary and only undertaken with the patient’s knowledge, consent and understanding that an HIV test is recommended.”

Disability advocates have also been calling on INZ to remove these medical requirements.

Faafoi told Newsroom last week he planned to review the Ash threshold.

“The details of the health requirements are still being worked through and will be made publicly available once immigration instructions have been signed.”

The Ash requirements for the newly announced one-off 2021 Resident Visa would not be reviewed, he said.

“The health requirements will be limited and will only screen for the most serious health conditions.”