Acquired immunodeficiency syndrome

Definition: Disease state caused by infection with human immunodeficiency virus (HIV) that leads to slow destruction of victims’ immune systems, making victims highly susceptible to potentially life-threatening infections and cancers
Also known as: AIDS
Significance: The emergence of acquired immunodeficiency syndrome (AIDS) during the early 1980’s fostered a national hysteria in which fears of contracting the disease were directed against categories of people who were believed to be its main carriers, most notably homosexual men and intravenous drug users. In an effort to prevent the diseases’ spread, federal laws were modified to restrict travel and immigration into the United States.
The first official mention of what would become known as acquired immunodeficiency syndrome, or AIDS, by the U.S. Centers for Disease Control and Prevention was issued on June 5, 1981. That report chronicled the cases of five white gay residents of Los Angeles, California. Soon, public hysteria over the apparently high mobility of the disease’s high-risk groups—homosexual men, intravenous drug users, hemophiliacs, and Haitian immigrants—erupted. Medical experts added to this frenzy by recommending quarantine measures on the basis of limited facts. They apparently assumed that prosperous gay American and European men—who were the first visible faces of AIDS—were more prone to travel internationally than their heterosexual counterparts and that they might therefore spread the disease rapidly during their travels. Equally compelling to the public health establishment at that time was the fact that the market for medical blood supplies was no longer local but international. Because intravenous drug use had increased tremendously around the world during the permissive 1970’s, the danger of HIV-tainted blood reaching uninfected patients was growing.

Immigration Issues


Public fear of the spread of AIDS and HIV was growing at the same time the public was becoming more concerned about the immigration of undesirables. Some of this fear had a racist element. Scenes of black Haitian boat people trying to reach the United States were frequently in the news. Whereas lighter-skinned refugees from communist- ruled Cuba had been welcomed into the United States, the black-skinned refugees from Haiti’s right-wing government were looked upon with suspicion. The U.S. government officially classified them as economic, not political, refugees who could be turned away at will. Moreover, the fact that many Haitian would-be immigrants had been found to be carrying tuberculosis during the 1970s’s and AIDS during the 1980’s made them even less welcome. Meanwhile, growing fears of AIDS and HIV in the United States raised new calls for restricting the immigration of possible carriers.
During the summer of 1987, President Ronald Reagan faced mounting pressure to do something dramatic about the spread of HIV/AIDS. This pressure led to his embrace of North Carolina senator Jesse Helms’s proposal to add HIV to the U.S. Public Health Service’s list of “dangerous and contagious diseases” so it could be used as grounds for barring possible carriers from immigrating into or even visiting the United States. Only one month earlier, Reagan had ordered the Public Health Service to add HIV to its contagious disease list through an executive order, even though it was becoming generally known that the infection was not spread through casual human contact—which was the conventional legal and medical interpretation of “contagious.” Under this ruling, travelers carrying HIV could be banned from entering the United States. Congressional ratification of the ban made it much more politically appealing in the short term. It also made the ban bureaucratically stronger over the long haul. Enacted during the height of the culture wars over both morality and immigration, restrictions on the immigration of AID/HIV carriers would remain on the books until the year 2008.

Effects of the Ban


The codified American ban on the entry of HIV carriers into the United States had the ironic effect of interfering with the exchange of academic and scientific information designed to stem the disease’s spread. A typical example of this obstruction was the harassment of Dutch AIDS-prevention specialist Hans Paul Verhoef in April, 1989, by the Immigration and Naturalization Service (INS). The INS apparently detained Verhoef after specimens of the only known medication for HIV/AIDS were found in his luggage. His detention was temporary, but it caused Verhoef to miss an important professional conference on AIDS in San Francisco.
International conferences on AIDS held in the United States during the early and mid-1990’s secured waivers for foreign participants infected with HIV/AIDS to enter the country. However, the granting of these waivers was slow, arbitrary, and begrudging. Consequently, the growing militancy of AIDS advocacy groups such as ACT UP during the administration of George H. W. Bush connected the travel and immigration ban to what they perceived as bureaucratic indifference and contempt that had made a bad situation worse. Even the merciful inclusion of persons infected with HIV/AIDS as a protected group under the Americans with Disabilities Act in 1990 did little to mitigate the effects of the travel and immigration ban.

Developments During the 1990’s


Bill Clinton’s presidency brought new hope to end the travel ban. However, as was often the case in gay-related and AIDS issues at that time, these hopes were dashed. Indeed, Clinton and the U.S. Congress renewed the ban, apparently to appease advocates of traditional family values. Shifting demographic trends in the incidence of the disease, which was afflicting increasing numbers of heterosexual Americans, had little effect in galvanizing support for repeal of the ban. The adoption of safer-sex practices during the 1980’s had leveled off the disease’s mortality rate and spread among gay white men by 1995, but the incidence of the disease was continuing to rise among both male and female African Americans of all sexual orientations.
The introduction of retroviral cocktail drugs after 1996 transformed HIV/AIDS froma deadly to a chronic disease, at least among victims who could afford the taxing regimen of medications that were becoming available. Meanwhile, the worldwide and increasingly heterosexual scope of HIV/AIDS was becoming publicly evident, and the disease’s ravages were a growing concern for American national interests and security, particularly in sub- Saharan Africa.
The trend toward an African—or foreign—face for HIV/AIDS may have ironically given the travel ban within the United States a second wind at the turn of the twenty-first century. That attitude was further strengthened by a fresh set of fears about immigrants in general after the September 11, 2001, terrorist attacks on the United States that prompted unprecedented new security measures to protect national borders.
In the meantime, routine obstruction and harassment of AIDS victims by federal government agencies continued. For example, Andrew Sullivan, the noted English pundit and editor, could not apply for American citizenship because of his HIV-positive status. Christopher Arnesen, an immigrant from New Zealand, had to fight a protracted legal battle to get the Social Security benefits he had earned from working for twenty-eight years in the United States. Eventually, however, the federal government relented. In what may be regarded as one of the most positive legacies of his administration, President George W. Bush committed the United States to help stop the spread of HIV/AIDS and assist its victims in Africa. At his prompting, the Democratic-controlled Congress quietly repealed the ban in 2008, ending nearly a full generation of discrimination against AIDS sufferers.
Charles H. Ford

Further Reading
Andriote, John-Manuel. Victory Deferred: How AIDS Changed Gay Life in America. Chicago: University of Chicago Press, 1999. Excellent analysis of the devastating impact of the disease in the United States during the 1980’s and 1990’s.
Chalmers, James. Legal Responses to HIV and AIDS. London: Hart, 2008. Comprehensive look at interconnections between immigration and HIV/ AIDS issues.
Gordenker, Leon, Roger Coate, Christer Jonsson, and Peter Soderholm. International Cooperation in Response to AIDS. London: Pinter, 1995. Excellent account of the conference controversies of the late 1980’s and early 1990’s.
Lalou, Richard, and Victor Piché. “Migrants and AIDS: Risk Management Versus Social Control— An Example from the Senegal River Valley.” Population, English Edition 59, no. 2 (March-April, 2004): 195-228. Study of the interrelationships among migration, immigration, and HIV/AIDS fears in sub-Saharan Africa.
Nelson, Leonard J. “International Travel Restrictions and the AIDS Epidemic.” American Journal of International Law 81, no. 1 (January, 1987): 230-236. Early survey of global exclusions put in place before the Helms amendment.
See also: Gay and lesbian immigrants; Haitian immigrants; Health care; History of immigration after 1891; Immigration law; Infectious diseases; “Undesirable aliens.”

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