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  1. 1
    350836
    Peer Reviewed

    HIV-related restrictions on entry, residence and stay in the WHO European Region: a survey.

    Lazarus JV; Curth N; Weait M; Matic S

    Journal of the International AIDS Society. 2010; 13:2.

    BACKGROUND: Back in 1987, the World Health Organization (WHO) concluded that the screening of international travellers was an ineffective way to prevent the spread of HIV. However, some countries still restrict the entrance and/or residency of foreigners with an HIV infection. HIV-related travel restrictions have serious implications for individual and public health, and violate internationally recognized human rights. In this study, we reviewed the current situation regarding HIV-related travel restrictions in the 53 countries of the WHO European Region. METHODS: We retrieved the country-specific information chiefly from the Global Database on HIV Related Travel Restrictions at hivtravel.org. We simplified and standardized the database information to enable us to create an overview and compare countries. Where data was outdated, unclear or contradictory, we contacted WHO HIV focal points in the countries or appropriate non-governmental organizations. The United States Bureau of Consular Affairs website was also used to confirm and complement these data. RESULTS: Our review revealed that there are no entry restrictions for people living with HIV in 51 countries in the WHO European Region. In 11 countries, foreigners living with HIV applying for long-term stays will not be granted a visa. These countries are: Andorra, Armenia, Cyprus (denies access for non-European Union citizens), Hungary, Kazakhstan, Moldova, the Russian Federation, Tajikistan, Turkmenistan, Ukraine and Uzbekistan. In Uzbekistan, an HIV-positive foreigner cannot even enter the country, and in Georgia, we were not able to determine whether there were any HIV-related travel restrictions due to a lack of information. CONCLUSIONS: In 32% of the countries in the European Region, either there are some kind of HIV-related travel restrictions or we were unable to determine if such restrictions are in force. Most of these countries defend restrictions as being justified by public health concerns. However, there is no evidence that denying HIV-positive foreigners access to a country is effective in protecting public health. Governments should revise legislation on HIV-related travel restrictions. In the meantime, a joint effort is needed to draw attention to the continuing discrimination and stigmatization of people living with HIV that takes place in those European Region countries where such laws and policies are still in force.
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  2. 2
    281426

    Global Consultation on the Health Services Response to the Prevention and Care of HIV / AIDS among Young People. Achieving the Global Goals: Access to Services. Technical report of a WHO consultation, Montreux, Switzerland, 17-21 March 2003. A WHO technical consultation in collaboration with UNAIDS, UNFPA, and YouthNet.

    Global Consultation on the Health Services Response to the Prevention and Care of HIV / AIDS among Young People. Achieving the Global Goals: Access to Services (2003: Montreux)

    Geneva, Switzerland, World Health Organization [WHO], Department of Child and Adolescent Health and Development, 2004. [80] p.

    Young people (10-24 years) are at the centre of the HIV epidemic in terms of transmission, impact, vulnerability and potential for change. The global goals on young people and HIV/AIDS that have now been endorsed in a wide range of fora reflect both the strong public health, human rights and economic reasons for focusing on young people, and also the concern and commitment of governments around the world to direct resources to the prevention and care of HIV/AIDS among adolescents and youth. In order to contribute to the growing clarity about what needs to be done to achieve these global goals, and to strengthen the collaboration between a range of UN and NGO partners committed to accelerated health sector action, WHO organized a technical consultation on the health services response to HIV/AIDS among young people, in collaboration with UNAIDS, UNFPA, UNICEF, and YouthNet, in Montreux, from 17 to 21 March 2003. The consultation sought to obtain consensus around evidence-based health service interventions for the prevention and care of HIV among young people; effective strategies for delivering these interventions, the essential characteristics of successful programmes; and the strategic partnerships and actions at global and regional levels that will be required to stimulate and support action in countries. It is now widely accepted that the prevention and care of HIV/AIDS among young people will require a range of interventions from a range of different sectors. The health sector itself will be responsible for a number of different interventions, through a range of health system partners. The consultation brought together UN, NGO and academic partners, and provided the opportunity for these diverse actors to review the evidence for action: what was understood by “evidence”, the available evidence about increasing young people’s access to priority services, and what could reasonably be inferred or extrapolated from the available evidence from other age groups. (excerpt)
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  3. 3
    103410

    Technical advisory meeting on implications of the newly identified HIV-1 subtype O viruses for HIV diagnosis. Press release.

    World Health Organization [WHO]. Office of Information

    Geneva, Switzerland, WHO, 1994 Jun 24. 2 p. (Press Release WHO/50)

    HIV is characterized by an high level of genetic diversity. HIV types HIV-1 and HIV-2 have been identified, and HIV-1 variants have been grouped by their gag and env sequences into at least eight subtypes, subtypes A-H. Divergent HIV-1 subtypes also have recently been identified which cannot be classified in any of the existing HIV-1 subtypes and are thus designated as subtype O for "genetic outliers". Limited available sequence data from HIV-1 subtype O viruses suggest that diversity within the subtype O group may be as great as that which exists between HIV-1 subtypes A-H. The majority of virus strains classified as HIV-1 subtype O have been isolated from patients of Cameroonian origin or their sexual contacts although recent preliminary studies in Cameroon suggest that less than 10% of HIV-1 infections there are caused by subtype O strains. A few subtype O infections have also been reported in Gabon and France, but limited studies have found no evidence of the presence of HIV-1 subtype O in Belgium, Cote d'Ivoire, Kenya, Togo, and Zaire. The ability of currently available anti-HIV assays to identify individuals infected with subtype O has not been extensively studied. An informal consultation of 22 international experts on the implications of this newly identified subtype for HIV diagnosis took place June 9-10, 1994, at World Health Organization headquarters. In general, one is more likely to fail in detecting HIV infection because of the absence of antibody in the seroconversion window phase than from infection with an highly divergent HIV subtype. The existence of these subtype O viruses is therefore likely to have little, if any, impact upon HIV diagnosis and blood safety outside of the area where they are prevalent. The expert group recommended that diagnostic tests and strategies for HIV antibody testing be urgently reevaluated in the region where subtype O virus has been found, a panel of sera be collected from asymptomatic and symptomatic individuals to use in assessing the sensitivity of available HIV antibody assays for antibodies against HIV-1 subtype O, envelope genes of subtype O isolates be sequenced to provide information useful in the production of HIV antibody assays and the determination of the relatedness of HIV strains, expanding the global surveillance of newly recognized HIV subtypes, and developing and evaluating algorithms for the detection and further characterization of variant HIV strains.
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  4. 4
    084315

    HIV testing: reduce costs by all means, but not at all costs [letter]

    Simon F; Brun-Vezinet F

    Lancet. 1993 Aug 7; 342(8867):379-80.

    Some HIV specialists propose alternative strategies of anti-HIV antibody screening to reduce costs. A western blot (WB) test confirming a positive anti-HIV antibody screening test is the time-honored strategy. WHO has guidelines on how to interpret WB results and how to handle indeterminate patterns. Tests for p24 antigen may identify HIV infection in those cases where the WB test fails to detect HIV infection during seroconversion. Alternative strategies proposed by authors of an earlier article to reduce HIV testing costs are flawed. For example, in 1 strategy, a positive result in the first test or ELISA and a negative result in a second test based on antigens or in another screening test based on a different principle leads to medical workers telling the person that he/she is HIV seronegative. Yet, the negative results of the second test may be due to seroconversion. Even though the first test should be as sensitive as possible, a subsequent negative test result should require another blood sample to test for p24 antigen. A second proposed strategy uses a competitive ELISA as the second test, but these assays cannot detect HIV-2 infection. The authors pooled the samples to illustrate cost saving, but pooling data loses sensitivity, especially for rapid tests. Virologists from Hospital Bichat-Claude Bernard in Paris, France, and earlier demonstrated the loss of sensitivity of rapid tests among sera from 9 patients in the early stage of HIV-1 seroconversion. They further believed that the manufacturer should determine reliability, sensitivity, and specificity. WHO did not take the above information into account when it addressed reducing the costs of HIV screening tests. Realistic diagnostic strategies are indeed needed in countries with few resources, but unreliable testing should not be the result of cost reductions.
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