NAPWA

All permanent visa applicants aged 15 years or over are required to have an HIV blood test.

Members of a permanent visa applicant’s family who are over 15 and listed as dependants on the visa application are also required to be tested.

Children under 15 are tested for HIV, where they applying for a permanent visa or where they are included as dependants on an adult’s application, if:

• they are to be adopted by an Australian resident; or
• they have had blood transfusions; or
• it is clinically indicated (i.e., where there are other grounds to indicate that the child may be HIV positive).

Although on-shore applicants for protection visas are not subject to the health requirement, they must undergo a health check which includes an HIV test. HIV positive status will not affect the decision whether to grant a permanent protection visa.

For people applying for permanent residence from outside Australia (“off-shore”), the blood test is conducted by a doctor approved by the Australian Department Of Immigration and Citizenship. For people applying for residence from within Australia (”on-shore”), the test is conducted by a doctor engaged by Health Services Australia.

The Health Requirement as it applies to people with HIV

The only disease or condition which currently automatically results in the refusal of a visa for migrants and off-shore refugees is active tuberculosis (TB). Rejection of applications for people with active TB is made under the Public Health Criteria of the Migration Regulations.

Applicants with other diseases or conditions (including diseases and conditions which are disabilities, such as HIV), are potentially eligible for most visa sub-classes - subject to either meeting the health requirement or having the health requirement waived. Perceived risk to public health is not generally an issue for permanent visa applicants who are HIV positive, unless they also have active TB.

For migrants and off-shore humanitarian and refugee applicants with HIV (and for the otherfamily members on the same visa application), the main health requirement issue is the estimated future cost of antiretroviralA medication or other substance which is active against retroviruses such as HIV. medication and health care. This is because of the test that the Department of Immigration and Citizenship must apply. In this factsheet we refer to this test as the “cost/prejudice” assessment.

Where a visa applicant or family member is HIV positive, the cost/prejudice assessment involves the Department of Immigration and Citizenship considering the person’s likely lifetime health care and community service requirements in Australia in relation to their HIV positive status. They will fail the test if the Department considers that providing health care and community services would either:

• result in a significant cost to the Australian community: or
• prejudice other people’s access to Australian health care or community
  services.

In the light of appeals highlighting inadequacies in cost/prejudice assessments, there have been some improvements to the Notes for Guidance for Medical Officers that are used for cost/prejudice assessments. Under the revised Notes for Guidance for Medical Officers, the only cost assessed now for HIV-positive people on antiretroviral treatment is the cost of medication1. Despite these improvements many people living with HIV still fail the health requirement initially.

Applying for permanent residence in Australia: Information for people with HIV and their advisors