HIV+ expat permits considered case by case

| 04/07/2019 | 28 Comments
Cayman News Service

(CNS): Following the recent release by UNAIDS calling on the Cayman Islands and 47 other countries to lift restrictions on people seeking to visit, study or work who are HIV positive, officials here have said that there is no mandatory restriction and that each case is considered on its own merit based on medical expert advice and the circumstances of a work permit applicant. A report on CNS last week stirred up considerable debate among CNS readers, many of whom supported a ban.

Responding to CNS enquiries on the issue, Workforce Opportunities and Residency Cayman (WORC) Director Sharon Roulstone explained in detail that the approach in considering applicants for work permits who tested positive for the HIV virus depended on a number of factors. She said the law and regulations governing WORC require the boards and director to be satisfied that anyone wanting to live and work in the Cayman Islands is in good health.

“This is tested by way of a medical questionnaire that must accompany all work and residency applications,” Roulstone told CNS. “Where it is found that an applicant has tested positive for the HIV virus or in fact any communicable disease, decision-makers defer to the chief medical officer (CMO) at the HSA for guidance. Whilst our policy in this regard is unwritten, it is well established. Every case is considered on its own merits with guidance provided by the CMO.”

She said that although the HIV virus is communicable, refusing an application based on the risk of transmission alone is not advisable. 

“A decision to refuse can be made, however, if the applicant is likely to become a significant burden to the health system,” she added, pointing to considerations such as the need for lifelong antivirals, periodic testing, counselling and monitoring, as well as the lack of health cover in the basic health insurance plan for most workers.

“HIV positive patients therefore must be able to prove that their private medical insurance (not CINICO) will cover all HIV related costs,” Roulstone stated. “The law also gives the relevant decision-makers discretion to consider the wider public interests when deciding whether or not to grant an application based on the health of the worker.”

She noted that the nature of the occupation would also be a point to consider in the decision and whether or not it would create potential for an increased risk of transmission.

But Roulstone was clear that government was cognizant of the need not to discriminate against people because they are HIV positive.

“We recognise the rights of all individuals and as far as possible make decisions that are not discriminatory based on the health of the person,” she said. “We appreciate that rarely are two cases ever the same and that the risks of transmission will accordingly vary. Our policy therefore is to consult with the CMO and be guided by him before making a health-related decision.”

The policy of consulting the CMO is long established and best practice, and Roulstone believes that no one has been banned from working in Cayman purely on the grounds of their HIV status without consultation with the CMO and consideration of the wider application, on a case by case basis. She further noted that any change to the current requirements would be a matter for Cabinet and the legislature.

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Category: Health, Medical

Comments (28)

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  1. Anonymous says:

    As long as they are not allowed on any Health Plan and can prove sufficient income to get treatment, it will be ok. Health insurance is already way to high on this island.

  2. Just Saying says:

    Are all the lawmakers in Cayman, retarted, comatose or downright stupid. Why is this even being considered. In the US, if a person tries to get a work permit or residency and has any kind of communicable disease, they are automatically eliminated from the process and denied stay. Consider the population of the Cayman Islands and the fact that 95% of men there do not respect the sanctions of marriage or monogamous relationships and that is from the very top of the ladder, HIV could spread like wildfire. WAKE UP CAYMAN!!!!!!!!

  3. Anonymous says:

    CAYMAN HIV FACTS (as of 30SEP18):

    CATEGORY MALE FEMALE TOTAL %
    MSM 39 0 39 24.0
    BISEXUAL 10 1 11 6.7
    HETEROSEXUAL 47 52 99 61.1
    PERINATAL 0 4 4 2.5
    IV DRUG ABUSE 1 2 3 1.8
    UNKNOWN 5 1 6 3.7
    TOTAL 102 60 162 100.0

    https://www.hsa.ky/public_health/hiv-and-aids-data-in-the-cayman-islands-as-of-30th-september-2018/

    • Anonymous says:

      What are you trying to say?

      • Anonymous says:

        162 HIV/AIDS residents in Cayman since records began (many sadly deceased), most heterosexual, and some were just babies. It isn’t a foreigner’s problem. We need to be mentally open to learning our way out of false health and social stigmas, by looking at the stats of our own people, and acknowledging and accepting how transmission actually occurs – evidence is what should instruct the subsequent precautions.

      • Anonymous says:

        That there are homosexual and bisexual carriers are outnumbered 2 to 1 by straight – for all those posters on here who think its a gay disease.

    • Anonymous says:

      What is MSM? By process of elimination I assume it means gay.

  4. Anonymous says:

    We Caymanians DON’T want no one with Hiv/Aids coming here on a work permit, period, we have enough problem now.

    • Anonymous says:

      Instead let’s just keep you and your ignorance. Oh please.

    • Anonymous says:

      Given that most cases exist amongst Caymanians, many of whom will have travelled and not kept their pants or protection on, perhaps it is travellers and wp applicants that should be warned about us instead. Also, Caymanians are not being routinely tested whereas wp applicants are, so there is only one population that we should be worried about. Think about it.

    • Anonymous says:

      fakey fake subverter

  5. anon says:

    One thing to have a “policy”, another, to actually follow it. How many people with HIV have been allowed in?.

  6. Anonymous says:

    This is so disturbing to me cant wait for another Ivan to pass through

  7. Anonymous says:

    Well that should have been communicated to the wider Cayman population years ago. There are many many locals and expats alike that take the island to be a real life sin city where anything goes because everyone thinks that they are safe from STDs and AIDS/HIV.

    • Anonymous says:

      …ignorance of the law is no excuse!

    • Anonymous says:

      I’m sure you are being sarcastic but that’s not funny at all. Nor is it true in any way shape or form.
      If you or anyone else believes, if that was the case, you are the biggest fool ever. The ONLY chance of protection is using condoms. Period.
      It is unfortunate that sex ed is not taught in schools since it is people like you that ‘educates’ others with locker room chatter of this type.

    • Anonymous says:

      In the year 2019? Most people stopped having unsafe sex in 1983. Do you all get like CNN there? That is so unbelievable it is farcical!

      Anyway the law is by very nature discriminatory, there is no way around it.

  8. Anonymous says:

    Great answer Sharon. Hopefully that will silence the critics (both local and overseas). The Department’s position on this issue is lawful and balanced, rational and proportionate. It is a model of how difficult issues should be confronted. Congratulations are deserved.

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