New Zealand Migration Law for People Living with HIV and Chronic Hepatitis
In recent years, there has been increased attention among advocates focused on the experiences of migrants living with blood-borne viruses, including HIV and hepatitis B. According to the World Health Organization, about 1 in 8 people worldwide are migrants. Migrants are also often a public health priority group for HIV, which is more prevalent among migrant populations than people residing in their country of birth. The epidemiology of hepatitis B follows a similar trend: in 2019, around 44% of all newly reported cases of hepatitis B in Australia were among people who were born overseas, with most of these originating in countries with high hepatitis B prevalence rates.
Australia also has significant restrictions on migration and travel for both people living with HIV and chronic hepatitis. People living with HIV who wish to migrate to Australia face significant barriers to entrance. These were ameliorated somewhat in July 2019, but only for people applying for temporary visas of up to three months. For longer-term visas, people living with HIV must still meet a set of health criteria, in a process that includes an assessment of the expected cost of their healthcare needs to the Australian community.
Addressing these and other legal issues affecting people living with blood-borne viruses who wish to migrate to Australia is critical to achieving health equity and justice in this country.
In this context, recent changes to HIV-related migration law in New Zealand have been some cause for celebration. In late 2021, UNAIDS welcomed the news that New Zealand had ‘removed all travel restrictions for people living with HIV’, while New Zealand’s LGBTQ+ magazine YOUR EX wrote that ‘New Zealand will now join a list of 203 countries that no longer impose HIV related restrictions on entry, stay and residency.’
While this news was widely interpreted to mean that people living with HIV might now be able to freely migrate to New Zealand – avoiding the kind of health criteria that Australia imposes on visa applicants – this is not entirely accurate. New Zealand’s changes in fact brings the country more closely into alignment with the Australian approach.
The Acceptable Standard of Health Test
New Zealand migration law has an acceptable standard of health test, known as the ‘ASH test’, which is very similar to the health criteria used in Australia.
There are a set of medical conditions that are deemed to impose significant costs and/or demands on health and/or special education services. On that basis, a person living with a listed condition will fail to meet the ASH test; however, should they meet all other requirements, they may be considered for the granting of a medical waiver.
People living with a chronic condition that is not listed may also fail the ASH test in cases where there is a ‘relatively high probability’ that the condition will exceed the cost threshold. Similarly, a medical waiver may be considered should they meet all other requirements.
As is the case in Australia, special exemptions apply to refugee visas.
The ASH Test and HIV
The recent reforms in New Zealand removed HIV from the list of conditions deemed to automatically fail the ASH test due to their associated healthcare costs. Australia does not maintain a list of conditions that will breach our health requirement, but instead assesses each applicant individually. New Zealand now does the same in relation to HIV.
New Zealand has also recently significantly increased the cost threshold for their ASH test from NZ$41,000 to NZ$81,000. However, because HIV is a chronic condition, this cost is measured over the course of an applicant’s lifetime – in contrast with Australia’s approach, where the significant cost threshold is $86,000 over a maximum of ten years.
For this reason, as we understand it, most people living with HIV attempting to migrate to New Zealand will now:
Apply for a residency visa (excluding refugee visas)
Fail the ASH test for lifetime costs of over NZ$81,000
May be considered for the granting of a medical waiver.
This is certainly an enormous improvement from the previous law, where people living with HIV were deemed to automatically fail the ASH test simply on the basis of their HIV status, but there is still a long way to go.
The ASH Test and Hepatitis B
In the past, hepatitis B was listed as a condition that would lead to automatic failure of the ASH test. However, this is no longer the case. Now, a person living with hepatitis B will fail the ASH test if they:
Are hepatitis B positive, and
Meet criteria for antiviral treatment in New Zealand
This means that simply being hepatitis B positive is no longer immediate grounds for failing the ASH test, but only where a person meets criteria for antiviral treatment. While more expansive as a definition, the second part is a complex question that requires specialist medical advice, and that can be challenging for visa candidates to navigate.
The New Zealand Immigration and Protection Tribunal has clarified that when a medical assessor concludes that an applicant meets criteria for treatment, they must provide reasons for their assessment. Importantly, being eligible for treatment is not the same as meeting criteria for treatment. The opinion that an individual meets criteria for antiviral treatment must be certain, explicit and supported by evidence.
For people who are living with hepatitis B but do not meet the criteria for antiviral treatment, the same process is likely to apply as it now does to HIV: an assessment as to whether the condition over a person’s lifetime will exceed NZ$81,000 and thus fail the ASH test in that way. As with HIV, a medical waiver may be granted for some applicants.
In Australia, recent changes to the SCT and a reduction in the cost of hepatitis B treatment medication means that it is now unlikely a person living with hepatitis B will fail the health requirement.
Disclaimer
This information is current to our best knowledge at the time of publication (September 2025). This is not legal advice and is provided subject to our disclaimer.
If you or someone you know is living with HIV or hepatitis B and seeking to migrate to New Zealand, it is recommended that you speak to a qualified lawyer or migration adviser in New Zealand for specific and up-to-date legal advice.