Entry regulations		Residence regulations		Additional information
No restrictions for people living with HIV.		Applicants who want to stay for more than 6 months to visit, study or work must undergo an immigration medical examination in certain circumstances. Permanent immigration to Canada: the applicant will be assessed based on whether they can reasonably be expected to place an “excessive demand” on Canada’s publicly funded health or social services.		In 2018, tripling of the cost threshold representing an “excessive demand” for immigration purposes made it easier for people living with HIV to immigrate to Canada. This is because the cost of many publicly funded HIV medications falls below the revised threshold.

HIV-specific entry and residence regulations for Canada

Editor’s note

In the past, it was difficult for people living with HIV to immigrate to Canada due to limitations set by federal immigration legislation. In the federal government’s most recent revision (April 2021), the cost representing an “excessive demand” for the health care system was increased to $21,798 CAD. This is likely to remove most, but not all, barriers to immigration for people living with HIV. We refer to the HIV Legal Network statement below.

Entry and residence regulations

• A person who intends to temporarily stay in Canada for less than 6 months (e.g. to visit, study or work) generally doesn’t need a medical examination which includes an HIV test, unless they are coming to Canada to work in a job that brings them into “close contact with people” such as workers in health-care settings, clinical laboratory workers, or agricultural workers from certain countries.

• A person who intends to temporarily stay in Canada for more than 6 months must undergo a medical examination which includes an HIV test if:
• In the previous year, they spent six or more consecutive months in a country designated by Canada as having a higher prevalence of serious communicable disease than Canada;
• They are coming to Canada to work in a job that brings them into “close contact with people” (e.g. workers in health-care settings or clinical laboratory workers); or
• They are applying for a parent and grandparent super visa.

• Everyone who applies to become a permanent resident of Canada must have an immigration medical examination which includes an HIV test. Canada assesses the results of the examination and decides if the applicant can reasonably be expected to place an “excessive demand” on Canada’s publicly funded health or social services. If an applicant’s annual health care costs, including the cost of their HIV medication, do not exceed $21,798 CAD (as of June 2021), the person will not be considered to pose an “excessive demand” on Canadian health services, and may obtain permanent resident status.

• There are exceptions to the rule on “excessive demand” for the following groups of people:
• Refugee applicant living with HIV
• HIV-positive sponsored spouse or common law partner of Canadian citizen or permanent resident
• HIV-positive sponsored and dependent child of Canadian citizen or permanent resident
• April 16, 2018: Federal government announces changes under the Immigration and Refugee Protection Act

• Joint statement by the HIV Legal Network (formerly the Canadian HIV/AIDS Legal Network) and the HIV & AIDS Legal Clinic Ontario (HALCO):

• Today, after years of advocacy by HIV, disability and migrant rights organizations, the Minister of Immigration, Refugees, and Citizenship announced changes to the rules that exclude would-be residents of Canada based on projected “excessive demand” on health and social services. These changes, however, fall far short of the full repeal of the current flawed, discriminatory regime, which is what advocates called for and a Parliamentary sub-committee recently recommended.
  
  Under the Immigration and Refugee Protection Act (IRPA), foreign nationals are inadmissible as permanent immigrants to Canada if their health condition might reasonably be expected to cause an “excessive demand” on health or social services, or if their application to immigrate includes a family member in this situation. Due to the high cost of antiretroviral medications, people living with HIV are generally deemed medically inadmissible if they apply to immigrate to Canada.
  
  Today’s proposed changes include increasing the cost threshold for defining what constitutes “excessive demand,” to three times the current level of $6,655 per year. This increase to the cost threshold may mean that many people living with HIV will no longer be found medically inadmissible and excluded from immigration to Canada. We welcome this change.
  
  However, HALCO, the Legal Network, and many other disability and migrants rights organizations have long been calling for a full repeal of the medical inadmissibility regime. In November 2017, representatives from HALCO and the Legal Network appeared before the House of Commons Standing Committee on Citizenship and Immigration. We argued that the “excessive demand” barrier is (i) discriminatory, in violation of the Canadian Charter of Rights and Freedoms and Canada’s international human rights obligations; (ii) not in line with IRPA’s objectives; and (iii) costly, cumbersome and inefficient to administer. The Standing Committee agreed with our recommendation and called for the government to repeal the provision.
  
  Today’s changes are important first steps. But what is truly needed is a full repeal of the deeply flawed and discriminatory excessive demand regime. As the Minister himself said, this regime does not reflect Canadian values. It must end.
  
  For further information on why the excessive demand regime is problematic, please read our joint submission to the Standing Committee on Citizenship and Immigration (November 15, 2017): https://www.hivlegalnetwork.ca/site/submission-to-the-house-of-commons-standing-committee-on-citizenship-and-immigration-in-relation-to-its-study-of-federal-government-policies-and-guidelines-regarding-medical-inadmissibility-o/?lang=en

(Source: 1)

June 2005 effective changes to visitor visa process affecting entry into Canada for people living with HIV:

• Canada does NOT require people applying for a visa to enter Canada as a short-term visitor to disclose known HIV infection on the visa application form.
• Canada does NOT routinely impose mandatory HIV testing on short-term visitors, nor does it categorically bar visitors based on their HIV-positive status.
• HIV-positive status does NOT prevent a person from visiting Canada, but for the rare and exceptional circumstance where the person’s health condition is such that they are assessed as likely to require health and social services, during their stay in Canada, that will create an excessive demand on Canada’s public system (e.g., hospitalization). This is the same standard applicable to all persons.

(Source: 2)

 

HIV treatment information for Canada

Accessing health care in Canada is expensive for non-Canadian residents or visitors and the cost varies from one province to another.

Canada is a federation of provinces and territories and health care is the responsibility of each province or territory. Access to services can vary a bit from one province to another. In general, visitors to Canada need private health insurance from their home countries to pay for major medical costs here.

Some Canadian provinces have arrangements with Western European countries so that citizens of, for example, France, the UK or Italy may get emergency treatment in Ontario fairly easily in theory and vice versa. Even with this reciprocal arrangement, there may still be additional costs that a person (visitor) has to pay if he or she is from the EU and falls sick in Canada. And in some cases, hospitals here may require that the visitor pay the fees first, then get reimbursed by their home country's medical system back in Western Europe once they return home.

Here is what can happen in one province. If a doctor in Ontario writes a prescription for HAART, unless the resident of Ontario has registered with our province's catastrophic health care plan or has private insurance, they have got to go a drug store and pay the full cost for the drugs. Not every pharmacy will have the entire range of HAART medications, though the pharmacies of large hospitals in the big cities of Montreal, Ottawa, Toronto, Calgary, Edmonton, Vancouver and Victoria are more likely to have this. Non-residents also have to pay full rates for HAART (unless they are officially considered refugees) - that could easily amount to 1.000 Euros per month, depending on the amount of drug supplied. Although the cost of medicine in Canada is somewhat less than in the U.S., it is still expensive.

A couple of AIDS service organisations in Canada (one in Vancouver and another in Toronto) sometimes stockpile unused medication that is on-hand for people who are in Canada illegally. However, that supply is very limited and rationed and does not cover the full range of medicines used for HAART. 

(Source: 4)

 

HIV information / HIV NGOs in Canada

• Canadian AIDS Treatment Information Exchange (CATIE) 
  555 Richmond Street West, Suite 505
  Box 1104
  Toronto, Ontario M5V 3B1 Canada
  Toll-free hotline 1.800.263.1638
  www.catie.ca
  Services available in English and French

• HIV Legal Network
  1240 Bay Street, Suite 600
  Toronto, Ontario M5R 2A7
  www.hivlegalnetwork.ca
  E-mail: [email protected]

• Battista Smith Migration Law Group
  Law firm with extensive experience in advising clients on HIV and immigration to Canada.
  Web: www.migrationlawgroup.com

 

Global Criminalisation of HIV Transmission Scan

The Global Criminalisation Scan is an initiative of GNP+. It aims to collect and keep up to date information on national and state level laws criminalising the transmission of or exposure to HIV. It also aims to provide an easily accessible ‘clearing-house’ of resources, research, and initiatives on the subject and to provide a platform for advocacy initiatives.

Find out more about the scan and the criminalisation of HIV transmission legislation at http://criminalisation.gnpplus.net/.

 

Sources

1. HIV Legal Network / Réseau juridique VIH, Immigration and Travel to Canada for People living with HIV: Questions and Answers: www.hivlegalnetwork.ca/site/canadas-immigration-policy-as-it-affects-people-living-with-hiv-questions-and-answers/?lang=en
2. Sandra Ka Hon Chu, Deputy Director, HIV Legal Network / Réseau juridique VIH, June 30, 2021 

 

updated: 6/30/2021
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