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Author Topic: undetectable without ARVs?  (Read 3356 times)

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Offline sheeppainter

  • Member
  • Posts: 4
undetectable without ARVs?
« on: July 12, 2010, 02:43:23 PM »
This is regarding my HIV+ significant other. I am HIV-. In an attempt to immigrate, we discovered his HIV status. We were denied, and appealed. The question of whether or not he is on antiretrovirals has come up. If the answer is yes, the application for VISA will be denied. If the answer is "no" there is a slight chance the VISA will be approved. Obviously, the inclination is to not be forthcoming. And we are aware of the consequences.
They know he is HIV+. And at the time, status was at CD4 284. He subsequently began Atripla. He is now undetectable with rising CD4 (last count was around 424).
 
Three questions:
1. Can someone BE HIV+ and become undetectable without ARVs? We believe they will question this.
2. Can someone be HIV+ and have their CD4s rise this dramatically without ARVs? (I know there can be fluctuations from day to day, time of day to time of day....but how much fluctuation?)
3. Can one detect from a blood test the presence of ARVs without specifically testing for its presence?

Offline justin

  • Member
  • Posts: 21
Re: undetectable without ARVs?
« Reply #1 on: September 21, 2010, 10:34:57 PM »
Hi

You did not mention what country your coming from or going to?
The reason I ask is it was just the opposite for my wife.
When doing her green card in the USA we found she was HIV+ I am HIV-

But all that was required was a waiver form & that form had to show she was under a doctors care & would continue to be.
Along with the medication of course.

I realize this is an old topic & hope you folks did all right

Offline sheeppainter

  • Member
  • Posts: 4
Re: undetectable without ARVs?
« Reply #2 on: October 04, 2010, 10:26:13 PM »
Well...the topic isn't that old. No one ever really replied. I am U.S. citizen. He is Mexican. But were(are?) both attempting to immigrate to Canada. They do not allow anyone to immigrate if they are on ARVs and cannot demonstrate an ability to pay for them out of pocket, rather than tax their healthcare system.

Offline Realist

  • Member
  • Posts: 162
    • NotDownNotOut's Blog
Re: undetectable without ARVs?
« Reply #3 on: October 05, 2010, 02:03:26 PM »
Sheep, there is some good advice here (particularly in relation to persons from Mexico being able to immigrate to Canade with HIV with refugee status and in addition the fact that "excessive demand" does not applied to Investors, Entrepreneurs, the Self Employed or Skilled Workers). http://www.smith-hughes.com/publications.html

********************
Overview of Canadian Immigration Law and Policies on HIV

The Immigration and Refugee Protection Act has the following provisions on
medical inadmissibility:

Section 38. (1) A foreign national is inadmissible on health grounds if their health
condition
(a) is likely to be a danger to public health;
(b) is likely to be a danger to public safety;
(c) might reasonably be expected to cause excessive demand on
health or social services.

The first two grounds of danger to public health or public safety are rarely used
against persons with HIV. This would only be likely if there is evidence the HIV
positive person is engaging in high risk behaviour that endangers other persons,
such as sharing contaminated needles or engaging in unprotected sex, and is
refusing to cooperate with public health authorities.

Most HIV positive persons are refused because of the third ground of excessive
demand on health or social services. Presently, “excessive demand” is usually
defined as exceeding $15,000 of publicly funded health care costs over the next
5 years, but the assessment time can be extended to 10 years (and costs to
$30,000), if relevant to the medical condition. Not everyone who is HIV positive
will be found medically inadmissible because of “excessive demand”. The
current guidelines for assessing HIV cases state any applicant receiving antiretroviral
therapy (ARV) is inadmissible because of “excessive demand”.

Persons not on ARV are assessed according to their CD4 lymphocyte counts.

There are significant differences in law and policy depending on the type of
immigration status. The 3 major types of status are:

 Temporary Resident
 Applicant for Permanent Residence
 Refugees and protected persons

A Temporary Resident will be in one of 3 categories:
 Work Permit
 Study Permit
 Visitor

The medical examination requirements for visitors are set out at
http://www.cic.gc.ca/english/visit/medexams.html#occupational

Foreign nationals who are medically inadmissible as permanent residents may
still be admissible as temporary residents.

Work Permit Holders
Generally, no medical examination is required for work permits of less than 6
months duration. However, a medical examination is required if an applicant is to
work in an occupation in which protection of public health is essential.
Section 30(1) of the Immigration and Refugee Protection Regulations (IRPR)
requires certain temporary foreign workers pass a medical examination before
working in Canada.

Section 30(1)(b) IRPR sets out occupations essential to protection of public
health:
 Workers in health sciences
 Teachers of primary or secondary schools or other teachers of small children
 Domestic workers / Live-in caregivers
 Workers who give in-home care
 Day nursery employees
 Agricultural workers from designated countries/territories

Section 30(1)(c) IRPR requires that all foreign nationals who intend to be in
Canada for more than 6 months and have resided in a designated country for
more than 6 months within the year preceding arrival in Canada must pass a
medical examination. This examination includes testing for HIV. The designated
country/territory list includes most countries with exceptions such as countries in
Western Europe, the U.S.A., Australia, New Zealand, Japan. You can see the
complete list at http://www.cic.gc.ca/english/visit/dcl.html

Tourists and Students
Generally tourists and students who are coming to Canada for less than 6
months do not require a medical examination. A medical examination is required
if an applicant has resided or stayed in a designated country/territory for six
consecutive months or more during the one year immediately preceding the date
of seeking entry to Canada.

Applicants for Permanent Residence
Citizenship and Immigration Canada (CIC) has implemented HIV serological
testing since January 15, 2002 for all individuals aged 15 years and older who
apply for permanent residence.

There are two basic types of applications for permanent residence:
 Economic Class Applicants
 Family Class Applicants

Economic Class Applicants
Economic Class applicants are not exempt from medical inadmissibility due to
excessive demand. The Economic Class includes:
 Skilled Workers
 Self-employed Persons
 Entrepreneurs
 Investors

HIV positive Economic Class applicants who have been refused because of a
determination of medical inadmissibility due to excessive demand may:

 Apply for a Temporary Resident Permit
 Apply to Federal Court for leave for judicial review of the medical inadmissibility
decision

Family Class Applicants
Canadian citizens or permanent residents of Canada may sponsor their:
 Spouse (including same-sex spouses if legally married in one of the Canadian
jurisdictions that recognizes same-sex marriage)
 common-law partner (a same-sex or opposite-sex partner they have lived with
for at least one continuous year in a conjugal relationship)
 conjugal partner (a same-sex or opposite-sex partner they have been unable to
live with for one continuous year in a conjugal relationship but have been in a
conjugal relationship with for at least one year)
 Dependent child
 Mother or father
 Grandparents
Certain Family Class members are exempt from medical inadmissibility due to
excessive demand. These are:
 spouse
 common-law partner
 conjugal partner
 child
But not:
 father or mother
 grandfather or grandmother

An HIV positive Family Class member who is not exempt still has some options.
These include:
 the Canadian sponsor can appeal the refusal to the Immigration Appeal
Division (IAD) of the Immigration & Refugee Board
 the applicant can apply to Citizenship & Immigration Canada for a Temporary
Resident Permit (TRP)
 the applicant can apply to Federal Court for leave for judicial review of the
medical inadmissibility decision

Filing an appeal with the IAD is probably the best of the options. The grounds for
an appeal to the IAD are:
 Mistake of fact or law
 Humanitarian and compassionate considerations that warrant the granting of
special relief. This is significant because it gives a broader authority for decisionmaking
to the IAD than either the visa officer initially assessing the application or
a Federal Court judge on a judicial review application would have.

Temporary Resident Permits
A Temporary Resident Permit (TRP) s a document that allows inadmissible or
removable persons to legally enter into and/or remain in Canada for a temporary
period.

A TRP is issued under discretionary authority. No applicant has the right to
receive a TRP.

The applicant must show compelling reasons-either humanitarian and
compassionate or in the national interest. The guidelines used by visa officers to
assess TRP applications can be found at http://www.cic.gc.ca/manualsguides/
english/op/op20e.pdf


A TRP is valid for up to 3 years and may be renewed. A TRP holder can obtain
permanent residence after 3 years on TRP. Because a TRP is discretionary it
can be cancelled at any time and the holder deported. There is no discretion
involved in granting permanent residence to persons who meet the requirements
of the permit holders class. Person who remain continuously in Canada on a
permit for the specified time and do not become inadmissible on other grounds
will be granted permanent residence.

Even if a person knows they are HIV positive and will be medically inadmissible
because of excessive demand, they cannot directly apply for a TRP. You must
first file a permanent residence application and wait until after you are
determined to be medically inadmissible before you can file a TRP.
In most provinces and territories, immigrants who are found medically
inadmissible and issued a TRP are not eligible for publicly insured health
services.

Refugees and Protected Persons
Canada distinguishes between refugees making claims in Canada and those
outside of Canada in its immigration legislation and has created separate rules
for the two kinds of refugee claimants. Persons can make a refugee claim in
Canada either at a port of entry (airport or border crossing) when they first arrive
or at a Canada Immigration Centre. Persons who make refugee claims at a
Canadian visa office outside of Canada may be excluded as medically
inadmissible excessive demand as well as for danger to public health or safety.
Protected persons, Convention refugees or a person in similar circumstances are
exempt from medical inadmissibility due to excessive demand on health or social
services. After a refugee claimant has been determined by the Refugee
Protection Division to be a Convention refugee or a protected person they are
sent a Notice of Decision and can file their permanent residence application from
within Canada. Persons who are failed refugee claimants may apply for the Pre-
Removal Risk Assessment before they are removed from Canada. If they are
successful, they will be protected persons.

Protected persons and Convention refugees will still be required to take the
standard medical examination but cannot be excluded from permanent residence
because of their HIV status unless they are found to be a danger to public health
or public safety.

Refugee claimants are covered under the Interim Federal Health Program and
not under the Medical Services Plan while their claims are waiting for final
determination. This program is not as extensive as the MSP and is basically
designed to cover emergency medical services.

HIV positive refugee claimants may base their refugee claim on their HIV status.
The United Nations Convention on Refugees does not explicitly list HIV status as
one of the five grounds for claiming refugee status. However, there is case law
that one of the five grounds, “membership in a particular social group” refers to
groups defined by an “innate or unchangeable characteristic” such as gender,
linguistic background, or sexual orientation. HIV positive status certainly qualifies
as being an unchangeable characteristic and has been found to constitute
membership in a particular social group.

This may be either their only basis for claiming refugee status or may be in
addition to other grounds for claiming refugee status. For example, someone
who is a well-known AIDS activist could claim refugee status both because of
political opinion as well as their HIV status. Someone who is gay could also
claim refugee status because of their sexual orientation in addition to their HIV
status. It is to a claimant’s advantage to claim more than one ground of
persecution if there is evidence to support this.

Persons who have a well-founded fear of persecution because of their HIV status
should be determined to be Convention refugees. Persons whose only fear for
returning to their own country is because there is not the same level of health
services available to them as in Canada would not be determined as Convention
refugees.

From what countries have HIV-positive people made successful refugee
claims?

The published decisions from the Refugee Protection Division include claims
from:
Mexico
Egypt
Chile
Uganda
Peru
Antigua
Poland
St. Vincent
Philippines
Jamaica
Singapore
Vietnam
Ecuador

Just because there has been a previous successful refugee claim based on HIV
status from a certain country does not mean that all HIV positive refugee
claimants from that country will be accepted as Convention refugees. Each claim
must be determined on its own merits.

******************

Hope this helps.
23/02/10 Tests confirmed
25/02/10 13100 220 24%
12/03/10 19800 372 19%
26/03/10 Atripla
30/04/10 58 286 23%
28/05/10 45 222 21%
25/06/10 UD 301 23%
24/09/10 UD 283 22%
01/12/10 UD 319 23%
11/03/11 UD 293 28%
10/06/11 UD 423 24%
23/08/11 UD 389 26%
28/02/11 UD 315 34%

I blogged it all http://notdownnotout.blogspot.com

 


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