Global strategies to control infectious disease have historically included the erection of barriers to international travel and immigration. Keeping people with infectious diseases outside national borders has reemerged as an important public health policy in the human immunodeficiency virus (HIV) epidemic. Between 29 and 50 countries are reported to have introduced border restrictions on HIV-positive foreigners, usually those planning an extended stay in the country, such as students, workers, or seamen.
Travel restrictions have been established primarily by countries in the western Pacific and Mediterranean regions, where HIV seroprevalence is relatively low. However, the country with the broadest policy of testing and excluding foreigners is the United States. From December 1, 1987, when HIV infection was first classified in the United States as a contagious disease, through September 30, 1989, more than 3 million people seeking permanent residence in this country were tested for HIV antibodies. The U.S. policy has been sharply criticized by national and international organizations as being contrary to public health goals and human-rights principles. Many of these organizations are boycotting international meetings in the United States that are vital for the study of prevention, education, and treatment of HIV infection.
The Immigration and Nationality Act requires the Public Health Service to list “dangerous contagious diseases” for which aliens can be excluded from the United States. By 1987 there were seven designated diseases—five of them sexually transmitted (chancroid, gonorrhea, granuloma inguinale, lymphog-ranuloma venereum, and infectious syphilis) and two non-venereal (active tuberculosis and infectious leprosy). On June 8, 1987, in response to a Congressional direction in the Helms Amendment, the Public Health Service added HIV infection to the list of dangerous contagious diseases.
A just and efficacious travel and immigration policy would not exclude people because of their serologic status unless they posed a danger to the community through casual transmission. U.S. regulations should list only active tuberculosis as a contagious infectious disease. We support well-funded programs to protect the health of travelers infected with HIV through appropriate immunizations and prophylactic treatment and to reduce behaviors that may transmit infection.
We recognize that treating patients infected with HIV who immigrate to the United States will incur costs for the public sector. It is inequitable, however, to use cost as a reason to exclude people infected with HIV, for there are no similar exclusionary policies for those with other costly chronic diseases, such as heart disease or cancer. Rather than arbitrarily restrict the movement of a subgroup of infected people, we must dedicate ourselves to the principles of justice, scientific cooperation, and a global response to the HIV pandemic.
1. According to the passage, countries in the western Pacific have(A) a very high frequency of HIV-positive immigrants and have a greater reason to be concerned over this issue than other countries.
(B) opposed efforts on the part of Mediterranean states to establish travel restrictions on HIV-positive residents.
(C) a low HIV seroprevalence and, in tandem with Mediterranean regions, have established travel restrictions on HIV-positive foreigners.
(D) continued to obstruct efforts to unify policy concerning immigrant screening.
(E) joined with the United States in sharing information about HIV-positive individuals.
2. The authors of the passage conclude that (A) it is unjust to exclude people based on their serological status without the knowledge that they pose a danger to the public.
(B) U.S. regulations should require more stringent testing to be implemented at all major border crossings.
(C) it is the responsibility of the public sector to absorb costs incurred by treatment of immigrants infected with HIV.
(D) the HIV pandemic is largely overstated and that, based on new epidemiological data, screening immigrants is not indicated.
(E) only the non-venereal diseases active tuberculosis and infectious leprosy should be listed as dangerous and contagious diseases.
3. It can be inferred from the passage that(A) more than 3 million HIV-positive people have sought permanent residence in the United States.
(B) countries with a low seroprevalence of HIV have a disproportionate and unjustified concern over the spread of AIDS by immigration.
(C) the United States is more concerned with controlling the number of HIVpositive immigrants than with avoiding criticism from outside its borders.
(D) current law is meeting the demand for prudent handling of a potentially hazardous international issue.
(E) actions by countries in the western Pacific and Mediterranean regions to restrict travel are ineffective.
4. Before the Helms Amendment in 1987, seven designated diseases were listed as being cause for denying immigration. We can conclude from the passage that(A) the authors agree fully with this policy but disagree with adding HIV to the list.
(B) the authors believe that sexual diseases are appropriate reasons for denying immigration but not nonvenereal diseases.
(C) the authors disagree with the amendment.
(D) the authors believe that non-venereal diseases are justifiable reasons for exclusion, but not sexually transmitted diseases.
(E) the authors believe that no diseases should be cause for denying immigration.
5. In referring to the “costs” incurred by the public (Highlighted), the authors apparently mean(A) financial costs.
(B) costs to the public health.
(C) costs in manpower.
(D) costs in international reputation.
(E) costs in public confidence.