Spain : Mandatory HIV testing as a weapon on the borderlands

HIV tests have become a weapon in the broad arsenal used to enforce immigration controls in Europe. Although most countries do not have official policies of mandatory or forced testing, it should be clear that, at best, HIV testing of refugees and asylum seekers happens in conditions where informed consent - a precondition for any HIV test - is clearly not possible. At worst, testing is used to target HIV positive asylum seekers for deportation.

That moving from anecdotes to hard evidence, from uncovering to stopping such insidious and often covert practices, has proven extremely difficult goes without saying. And these violations have seemed to some to be a lesser evil, given that there are countries which openly forbid entry on the basis of HIV status.

Here, MAHA revisits the facts of one local campaign to stop mandatory HIV testing of asylum seekers in Spain. We believe there are important lessons to be learned from this campaign especially given that, two years after campaign’s end, the abuses denounced go on unchecked.

Blowing the whistle

In 1995, Spanish Red Cross workers blew the whistle on illegal HIV testing of asylum seekers, performed by their organization for the Spanish government.

In a carefully-worded editorial, the journal Sidapress wrote of its "preoccupation" with "obvious evidence of a double discrimination" which targets asylum seekers.

The Spanish Cruz Roja (Red Cross) is charged by the government to establish a medical certificate for all asylum seekers. The medical exam is required by a July 1985 law, but in October 1990, the National AIDS programme stated clearly that an HIV antibody test cannot, in principle, be made mandatory.

However, both the asylum seekers who tested HIV positive and those who refused to take the test were denied entry to the asylum centers or "reception centers" run by the Spanish Red Cross.

These centers provide minimal housing and work, so being kept out amounts to denial of access to the already meager social services - including minimal access to health care - granted to asylum seekers.

"No reason exists to justify" this practice, stated the editorial, arguing that it "violates the simplest and most logical criteria of public health."

Sidapress called for the Red Cross and the Spanish government to "explain their position" on this issue, and for AIDS and antiracist organizations to "demand, by all legal means available," the opening of a more thorough inquiry.

Fallout

In Bilbao, the T4 group (Association ciudadana de lucha contra le sida y autoapoyo entre los afectados T4) took up the issue, denouncing the practice to the media and writing to the Spanish Ombudsman and to the political parties to demand a public inquiry.

T4 documented the cases of seven people - 6 men and 1 woman - who had been denied housing and services either because they had tested HIV positive or because they had refused to take the test. According to T4 organizer Oskar Arroyuelo, who worked on the campaign, these asylum seekers were reluctant to go public with their story.

All seven were eventually deported. "The reasons given for deporting these people," explains Arroyuelo, "were not the fact that they had tested HIV positive, but for example that they had lied about their nationality."

Yet Red Cross workers directly involved in processing asylum applications insist that people who test HIV positive have their asylum claim denied on that basis, but say another reason is given as the official justification for rejection of an asylum claim and deportation.

The refugee workers who had exposed these practices, however, were too afraid of losing their jobs to testify publicly, explains Arroyuelo. This left T4 with no way to back up claims it knew were true.

Beyond Spain’s borders

It soon became clear that there would be no public inquiry into the allegations of abuse. Neither the government nor the Red Cross bothered to respond publicly to the charges.

However, in April 1996, T4 obtained an internal document addressed to the Red Cross staff responsible for the medical exams. In it, instructions for "total discretion" were given "to avoid continued denunciation by the T4 group." Since then, no one else has come to T4 about these practices.

T4 then organized a workshop on migrants and ethnic minorities as part of its third meeting for people living with HIV/AIDS, held in Bilbao in July 1996. Refugee aid workers, AIDS activists, and representatives of immigrant-run AIDS projects from Berlin and London met to discuss both the abuses and the broader need for HIV prevention and support of refugee and immigrant communities in Spain.

Although the Red Cross had been invited, they did not participate in the meeting.

T4 asked EuroCASO Executive Committee member Patrick Levy to take its request for a public inquiry of the abuses to the World Health Organization’s Global Programme on AIDS. "We must consider the problem of migration and of minorities," Levy said during the meeting, "as a global problem and hence must look for global solutions." However, both WHO and UNAIDS told MAHA they were never told of the abuses documented by T4.

Abuses continue

Two years later Arroyuelo remains convinced that discriminatory HIV antibody testing persists in Spain’s refugee centers, but say his organization still lacks the hard evidence of abuse necessary to put a stop to the practice today. "The only thing to do now," conclude Arroyuelo, "is not a campaign to tell the UN about the abuses, but a prevention policy to keep such abuses from happening." For T4, the campaigning is over.

For T4 and other groups in Spain, the campaign highlighted for the first time the very real needs of refugee and immigrant communities in Spain for HIV prevention and support which does not violate their human rights. It also sparked debate amongst AIDS organizations about immigration (despite obvious reticence to taking a cleary anti-racist position), and led to coalition-building with immigrant rights and refugee aid groups. nm

MAHA wishes to thank Stéphanie Grené for her help with translation for this article.