Mandatory disclosure in healthcare risks damaging public health work on HIV/AIDS

HIV-Sweden sent this text to the Ministry of Social Affairs by email on June 20, 2023.

The government intends to investigate whether public health care workers should report undocumented migrants. On SVT's 30 minutes in May, Minister of Justice Gunnar Strömmer stated that he does not intend to exclude any public employees in the upcoming investigation. If the proposal becomes reality, we may see more new cases of HIV, a larger number of unreported people living with HIV and a larger proportion of people with untreated HIV in Sweden.

Undocumented migrants living or staying with HIV in Sweden are currently entitled to care and medication under the Infectious Diseases Act. The law thus protects both the individual's life and health by providing access to treatment and prevents the spread of infection as HIV is not transmitted during treatment. The system is well balanced and a fundamental part of Sweden being the first in the world to reach the UNAIDS 90-90-90 target in 2015.

With the obligation to report that will now be investigated, we may instead see increased social exclusion with poorer infection control as a result. The proposal is intended to limit the right to welfare services, including health care, according to migration status. Infectious disease nurses, doctors and other health care professionals can then be required to report anyone who seeks care to test or treat their HIV and does not have the right to stay in Sweden. For individuals affected by the proposal, a sense of anxiety and resignation may arise. An imminent risk of deportation, together with the stigma associated with HIV, creates barriers to both HIV testing and access to medication.

Is the government prepared to risk the work against HIV/AIDS and public health? Will Sweden, which already has a dark history of criminalizing HIV, once again marginalize HIV and people living with HIV? 

Sweden still needs a sensible and balanced public health policy on HIV/AIDS. Making people face the choice of either seeking care for their life and health, or being forced out of the country, is the wrong way to go. HIV-Sweden therefore calls on the government to take this letter into consideration and to exclude, to the smallest extent possible, healthcare professionals who meet people living with HIV or work with testing in the directives for a future investigation. 

Eva Lilja,

President, HIV-Sweden