HIV Is No Longer a Ground of Inadmissibility

In January 2010, the U.S. Department of Health and Human Services (HHS) removed HIV from the list of communicable diseases of public health significance. This change means that HIV-positive status — regardless of viral load, CD4 count, or treatment status — is no longer a ground of inadmissibility under U.S. immigration law.

Prior to 2010, HIV-positive applicants were required to apply for a waiver to obtain a green card. That requirement no longer exists. Whether your HIV is detectable or undetectable, whether you are on antiretroviral therapy (ART) or not, and regardless of your CD4 count, your HIV status will not prevent you from obtaining a green card or other immigration benefit.

Undetectable Status Does Not Change Exam Requirements

Having an undetectable viral load — meaning HIV is not detectable in your blood using standard tests — is a significant health achievement and reflects effective antiretroviral therapy. However, for immigration purposes, the distinction between detectable and undetectable HIV is not legally relevant. HIV in any form is not a ground of inadmissibility, and your viral load will not be evaluated as part of the immigration medical examination.

The immigration medical exam does include a required HIV antibody test for all applicants aged 15 and older. If you are HIV-positive, this test will be positive regardless of your viral load. A positive HIV test result will be documented on Form I-693, but it will not result in a finding of inadmissibility. The civil surgeon is required to document the result accurately — this is a factual notation, not a negative determination.

HIV Medications and Live Vaccine Considerations

Antiretroviral therapy (ART) does not, by itself, contraindicate most vaccines required for the immigration medical exam. However, your immune status — specifically your CD4 count — may affect recommendations for certain live vaccines. Live vaccines, such as MMR (measles, mumps, rubella) and varicella, are generally safe for HIV-positive individuals with CD4 counts at or above 200 cells/mm³ but may be contraindicated for those with lower CD4 counts.

If you are on ART and have a suppressed viral load with a normal or near-normal CD4 count, you can generally receive all required vaccines. If your CD4 count is below 200 cells/mm³, inform the civil surgeon. Your infectious disease specialist or HIV provider may have specific guidance about which vaccines are safe for you at your current immune status.

Bring documentation of your current CD4 count and viral load if available. This information helps the civil surgeon make appropriate vaccine recommendations and document your immune status accurately. If your HIV provider has advised against specific vaccines, bring a letter from your provider explaining the contraindication.

What the Civil Surgeon Documents

The civil surgeon will document your HIV-positive status on Form I-693 based on the required HIV antibody test result. Your current antiretroviral medications will be recorded as part of your medication history. The physical examination will include a standard assessment, and any relevant clinical findings will be noted.

Form I-693 is sealed and submitted to USCIS. The documentation of your HIV status is a factual notation required by the examination protocol. Because HIV is not a ground of inadmissibility, this documentation will not negatively affect your immigration case. USCIS adjudicators are aware that HIV is no longer a ground of inadmissibility and will not treat a positive HIV test result as a basis for denial.

Confidentiality of Your Medical Information

The information documented on Form I-693 is confidential and is used solely for immigration purposes. The civil surgeon and clinic staff are bound by medical privacy obligations. Form I-693 is sealed in an envelope by the civil surgeon and is either given to you to submit with your green card application or submitted directly to USCIS, depending on the filing method.

USCIS handles Form I-693 as a confidential medical record. The information is not shared with other government agencies for purposes unrelated to your immigration case. If you have concerns about the confidentiality of your medical information, you may wish to consult with an immigration attorney who can explain how your medical records are handled in the immigration process.

What to Bring to Your Appointment

Bring a complete list of your current antiretroviral medications, including the name, dose, and frequency of each medication. If you have recent lab results showing your CD4 count and viral load, bring them to your appointment. These results are not required but can be helpful for vaccine planning.

Bring your complete vaccination records, a government-issued photo ID, and any documentation from your HIV provider regarding vaccine contraindications or other relevant medical guidance. If you have a history of opportunistic infections or other HIV-related conditions, bring relevant medical records if available.