Cordon Sanitaire or Healthy Policy? How Prospective Immigrants with HIV are Organized by Canada’s Mandatory HIV Screening Policy
Creators: name: Bisaillon, Laura
Publisher: name: Université d'Ottawa / University of Ottawa
Year: 2012
Subjects: HIV/AIDS
immigration medical examination
Immigration and Refugee Protection Act
institutional ethnography
ruling relations
social organization
textual mediation
mandatory HIV testing
political activist ethnography
policy
Canada HIV/AIDS screening

description: Since 2002, the Canadian state has mandatorily tested applicants for permanent residence for HIV (Human immune deficiency virus). The policy and practices associated with this screening have never been critically scrutinized. Authoritative claims about what happens in the conduct of the immigration medical examination are at odds with the experience of immigrant applicants living with HIV. This is the analytic entry point into this inquiry that is organized within the theoretical and methodological frame offered by institutional ethnography and political activist ethnography. Analysis is connected to broader research literatures and the historical record. The goal of this study is to produce detailed, contextualized understandings of the social and ruling relations that organize the lives of immigrants to Canada living with HIV. These are generated from the material conditions of their lives. An assumption about how organization happens is the social and reflexive production of knowledge in people’s day-to-day lives through which connections between local and extra-local settings are empirically investigable. I investigate the organization of the Canadian immigration process. How is this institutional complex ordered and governed? How is immigration mandatory HIV testing organized, and with what consequences to HIV-positive applicants to Canada? This is a text-mediated organization where all the sites are connected by people’s work and the texts they circulate. The positive result of an immigration HIV test catalyzes the state’s collection of medical data about an applicant. These are entered into state decision-making about the person’s in/admissibility to Canada. I focus on a key component of the immigration process, which is medical examination and HIV testing with this, along with the HIV test counselling practices that happen (or not) there. The reported absence of the latter form of care causes problems and contradictions for people. This investigation adopts the standpoint of these persons to investigate their problems associated with HIV testing. The main empirically supported argument I make is that the Canadian state’s ideological work related to the HIV policy and mandatory screening ushers in a set of institutional practices that are highly problematic for immigrants with HIV. This argument relies on data collected in interviews, focus groups, observations, and analysis of texts organized under Canada’s Immigration and Refugee Protection Act (S.C., 2001, c. 27) and textually mediated, discursively organized concepts that shape people’s practice. Canadian immigration medical policy makers should make use of these findings, as should civil society activists acting on behalf of immigrants to Canada living with HIV. I make nine specific recommendations for future action on HIV and immigration in Canada.