ALCOAST 217/26 - JUL 2026 HIV POLICY UPDATES - ACCESSIONS

R 131607Z JUL 26  MID120041380550U
FM COMDT COGARD WASHINGTON DC
TO ALCOAST
BT
UNCLAS
ALCOAST 217/26
SSIC 6110
SUBJ: HIV POLICY UPDATES - ACCESSIONS
A. Coast Guard Human Immunodeficiency Virus (HIV) Program,
COMDTINST 6230.9A
B. U.S. Department of War Memorandum from Under Secretary of War for
Personnel Readiness to Secretaries of the Military Departments dated
17 June 2026, subject: Exception to Policy to Comply with Court
Order in Wilkins v. Hegseth [(formerly Wilkins v. Austin),
Case No. 1:22-cv-1272] [sic]
C. U.S. Department of War, DoWI 6130.03, Volume 1, Medical Standards
for Military Service: Appointment, Enlistment, or Induction, May 6,
2018 as amended
D. U.S. Department of War, DODI 6845.01, Human Immunodeficiency
Virus (HIV) in Military Service Members, June 7, 2013, as amended.
1. This ALCOAST updates REF (A) as promulgated in REF (B).
2. REF (B) directs a temporary exception to REF (C). This temporary
exception complies with the Federal court order, Wilkins v. Hegseth,
and allows accession of certain individuals living with Human
Immunodeficiency Virus (HIV).
3. The Coast Guard accession standards are promulgated in REF (C).
Therefore, the Coast Guard will adhere to this temporary exception
to policy, which updates REF (C). REF (B) specifically directs a
temporary exception to the policy that would bar accessions for
individuals who are living with HIV, solely where the individual is
asymptomatic and has an undetectable viral load, that would result
from application of HIV-specific provisions of REF (C), REF (D),
and any other policy that would bar accessions for individuals
solely due to their HIV-positive status.
4. An individual living with HIV is "asymptomatic" when an
individual is not experiencing any HIV-related signs or symptoms,
or adverse effects associated with medical therapy, as determined by
the individual's HIV-treating provider and confirmed by an
authorized DoW, Coast Guard health care provider, or other
appropriately qualified official. An "undetectable viral load" is
defined as having clinically confirmed viral suppression of HIV, as
verified by the individual's HIV-treating provider and confirmed by
an authorized DoW, Coast Guard health care provider, or other
appropriately qualified official. To demonstrate clinically
confirmed viral suppression of HIV, an individual must show:
    a. Viral load measured as <200 copies/mL on all readings (minimum
of two, taken not less than 90 days apart) for a period of at least
6 months;
    b. Cluster of differentiation 4 (CD4) count measured as
> 350 cells/mm3 within the past 12 months (or last CD4 count
>500 cells/mm3); and
    c. Continuous compliance with an antiretroviral regimen for at
least the previous 6 months [and attest to an intention to continue
compliance].
5. No more than 90 days prior to shipment to initial training, the
medical status of HIV-positive applicants who are asymptomatic with
a clinically undetectable viral load will be confirmed, consistent
with the requirements set forth above and existing processes.
6. This temporary exception supersedes any restrictions currently in
Chapter 1 of REF (A).
7. This ALCOAST will expire on 13 JUL 2027.
8. POC: CAPT Gretchen Buckler, Chief, Preventive Medicine,
Population Health and HIV Program Manager (CG-CMO-1),
(202) 394-4440, Aileen.G.Buckler@uscg.mil.
9. RADM Charles E. Fosse, Deputy Commandant for Personnel (DCP),
sends.
10. Internet release is authorized.