Application forms for entry visas often contain questions about general health, such as “Do you suffer from a communicable disease?”
Those who decide to answer truthfully can expect entry to be refused. If HIV-positive travellers decide to answer this question untruthfully, they then encounter the subsequent problems of needing to hide any medication they are carrying and needing to give the healthiest possible impression to the border official(s).
At border checks, it is the job of officials to look at luggage and/or check completed forms. The checks may also include checks of physical appearance. If health certification is required when applying for the visa or for entry at the border, the required tests and examinations are frequently carried out by contractual doctors or other official bodies.
Only those who subject themselves to these regulations have a chance of entering the chosen country – apart from the option of paying bribes, as anecdotal reports suggest. Some countries require foreigners to have regular routine examinations which may include an HIV test.
The costs for all these tests must naturally be covered by the individual, putting financially weaker groups of people at a disadvantage.
Other checks are performed by agencies whose task it is to hire workers in foreign countries. In applications for healthcare professions (physicians, nurses, etc.) a negative HIV test is a prerequisite for even being invited to an interview.
In this manner, for instance, medical personnel is recruited from South Africa to work in the rich north. Other employers and other institutions such as universities also often openly require HIV tests as a prerequisite for employment, allocation of study places, and grants. In principle, anyone entering a country may find themselves in the position of having to provide information about “suspicious” fellow travellers.
An HIV-positive passenger from Japan on his way to China, when China still had its restrictions enforced, was sent back on the next airplane after a fellow passenger on the plane listened in on a conversation about HIV and reported him. There is a particularly significant strain when a traveller’s physical appearance makes it impossible to hide or deny illness.
It is then often at the discretion of the border official to order an examination.
People who refuse to subject themselves to this will not have the option to enter the country, as examples from Malaysia and other countries show.