USA

TRAVEL ALERT: U.S.

America displays a “Do Not Enter” sign to all HIV positive travelers from other countries, with exceptions only for people attending medical conferences or those with close relatives already here.

While it’s not hard to slip through customs -- and no one can make you take an HIV test without your written consent -- some HIVers do get turned away at the airport. Physical appearance can be key: Dress up and wear clothes that fit well, especially if your weight has changed. Make meds in your bags as nondescript as possible. Customs agents watch for people who look like they might try to illegally immigrate, so if you look young or don’t have a job, bring a letter showing that you have commitments in your home country.

If you need emergency care, U.S. hospitals should treat you regardless of your ability to pay, and your illegal entry shouldn’t be a problem there, either.

There is nothing like the sound and smell of the sea to bring me complete peace and relaxation. This is especially true on a sunny, breezy day when I can walk on the beach for miles and contemplate my place in the scheme of things without interruption. My trips to Florida afford me that opportunity, and I look forward to them as Canada’s icy winter winds begin to howl and the freezing rain and snow start to fall, threatening to leave me alone with my cabin fever. In recent years, Florida has become my regular mid-winter escape, a chance for some emotional and physical healing. Trips to the United States always offer a chance to stop in New York City as well, to visit experienced HIV doctors and to stock up on therapies that haven’t been approved yet in Canada (as I did once with saquinavir, long before protease inhibitors were available at home). But it’s never easy to get there.

Shortly after I was diagnosed with HIV a little more than seven years ago, I learned that I was now designated an “undesirable alien” by the United States and banned from traveling there. This news paled in comparison to the news that I was about to die -- one doctor told me I had only two years to live -- but soon travel to the United States took on considerable importance. I became quite ill with bronchitis in the fall of 1994, and friends suggested that I spend the winter in the South. I was desperate to do so but terrified at the prospect of having to explain to immigration officials the reasons for my visit. What if I were refused entry to the United States for a long period of time -- or indefinitely?

I decided to travel with my mother, using the excuse that I was taking her for the winter -- when, in fact, she was taking me. The form we had to fill out was simple, asking our destination, reason for traveling and the length of our visit; the troublesome part was when an immigration officer with the power to demand a search reviewed the form and then begin to ask us whatever questions she chose. She expressed pointed interest in the fact that my company had allowed me such a long leave from work, but when I didn’t volunteer a response, thankfully, she let it go.

Every trip I make to the United States requires careful planning. I’m not a good liar so I stick as close to the truth as I can, but crossing the border is still terribly nerve-wracking. And lying to officials about my health, as a woman who’s normally very open about my HIV status, always feels like a real indignity. I’ve wanted to tell the truth to immigration officers so many times, but at the border, you never know what to expect.

These trips have become more perilous in the age of drug therapies because I have to carry all of my meds with me -- and they’d be almost impossible to explain if I were searched. I’m presently on a three-drug combination of d4T, 3TC and Crixivan, plus prophylaxis for PCP and herpes as well as a thyroid replacement -- a total of 13 pills per day. I always take along several types of antibiotics, a vitamin supply and some painkillers -- just in case. So whenever I travel, I have with me at least 20 bottles of pills. I can’t even spread them around my luggage to make them look less conspicuous; since I can’t afford to risk losing them, I pack them all into my carry-on. (Once, to avoid all this, I tried to mail pills across the border, but they were stopped at customs and shipped back to my doctor.)

Those of us who travel to the States swap stories from time to time, and the common thread is feeling disrespected and afraid. I remember a trip with one friend who has more pronounced outward signs of AIDS than I do. He was so anxious at the border that I thought he was going to confess his HIV status without even being asked. Another friend’s bags were randomly searched, and his pills were discovered. He was sure his goose was cooked but stated honestly -- if vaguely -- that they were “antiviral drugs.” For whatever reason, he was allowed to cross with no further discussion. He has never forgotten the close call, and neither have I. You would think that after successfully crossing so many times, I’d stop worrying about being caught. But I never do. Once is all it takes to be sent packing, and you never know when that time might come.

I accept the right of every country to set reasonable rules about who can enter its borders and for what purposes. The U.S. government is likely concerned that people like me will spread the disease or become sick during our stay and use public hospitals. But my own experience is that PWAs are of no risk to others during their visit, and certainly when Canadians become ill, we want to return home -- where health care is paid for and we’re near our own doctors -- as quickly as possible. From my vantage point, the travel restriction appears to be just another way to let HIV positive people know that we are not welcome or even tolerated -- as if we hadn’t already guessed.