Before you go

Being HIV positive can influence our decisions about travel in a number of ways. Many positive guys are cautious about travelling to places where they have reason to be concerned about their health, or where there is only limited access to quality medical services especially with experience in HIV medicine.

Some countries also have restrictions on travel for people with HIV, even for tourists. Carrying HIV treatments can therefore be a de facto admission of being HIV positive and may result in you being denied entry. Some people choose to minimise this risk by posting their treatments ahead, either to friends or to a PLHIV organisation that will hold the treatments for a short time. Remember that this does not always work: packages go missing or get held up. If you are posting ahead, do it in plenty of time and check that your treatments have arrived safely.

Entry and visa requirements for individual countries can be found on the The Global Database on HIV-Specific Travel and Residence Restrictions website.

On the move

Being on holidays means a big change to daily routines. Disruption or change to daily routines is one of the most common reasons for missing doses of HIV treatments.

Time zone changes and variations to normal daily routines are reasons for missing doses. If you have chosen a particular drug combination because it suits your lifestyle (around your eating, sleeping, and working patterns), travelling can upset this balance.

If you plan to stay in a new time zone for a week or more, you should consider changing your dose routine until it is in sync with the local time. This can be done by changing the dosing time gradually (by moving the dose slightly each time) until they fall at more convenient times. This is particularly important for drugs that need to be taken at regular intervals. Work out a schedule with your doctor.

If you are in a different time zone for only a few days, it may be easier to keep the same medication routine as at home. Book wake-up telephone calls or use an alarm clock to wake you for doses in the middle of the night.

If you are travelling with treatments, carry your prescriptions and a letter from your doctor with you. The letter does not need to reveal that you are HIV positive, but it should include the words: “These  medications have been prescribed for a medical condition,” and a list of all the medications you are on. Keep the letter and prescriptions separate from your medications, so that if you lose one, you do not lose the other. You do not need to declare your medications when you go through customs, but if a customs official checks your luggage and finds your medications, you may be asked to produce a doctor’s letter and the prescriptions. Keep the medication in the original bottles with your name on them. Some countries have strict laws on drug labelling.

Ask your doctor or Travellers’ Medical Centre for a detailed guide on avoiding food-borne diseases when you are away. In countries with different food hygiene standards, it is best to avoid tap water, uncooked food (shellfish, salad and fruit dishes) and some meat products. Boiled or bottled water (sealed), thoroughly cooked food and fruit you have peeled yourself (with clean hands) are safest.

Taking a treatments holiday?

Going on holiday is also a time when many people consider taking a break from treatment—sometimes also called a drug holiday.

Although it may seem easier to stop taking your pills altogether rather than having to plan ahead with doctors’ certificates or sending the treatments to your destination beforehand, recent research has shown that taking treatments breaks can have serious negative consequences to your health and overall management of HIV disease progression in the medium and longer term, and are therefore not recommended.

Vaccinations

For overseas travel, tell your doctor where you are going and check for any special medication or vaccination requirements.

For people who are HIV positive it is important not to be given any “live” vaccinations. These usually include vaccinations for yellow fever, TB, measles, and typhoid oral dose vaccine. Some anti-diarrhoea treatment can be useful, but ask your doctor which ones are suitable for people with HIV.

Medicare and travel insurance

Australian residents are entitled to “immediately necessary medical and public hospital treatment” under reciprocal health care agreements with a number of countries.

HIV related conditions should be covered by this arrangement, however ongoing HIV therapy would be at the discretion of each individual country. The exact nature of the agreement between Medicare and each of these countries differs slightly.

For information regarding these agreements visit the Medicare Australia website. To access emergency medical care under the reciprocal health care agreement, in any of these countries, you are required to present your Australian passport as well as your current Medicare card. Medicare also recommends taking travel insurance in case your situation is not covered by these agreements. Insurance is strongly recommended for the United States of America where the cost of health care is extremely high. However, while most illnesses and conditions are covered by private travel insurance regardless of HIV status, illnesses directly related to HIV are not generally covered by private travel insurance.

Specific country information and hints and information for Australian travellers can be found through the Department of Foreign Affairs and Trade.

Also The Global Database on HIV-Specific Travel and Residence Restrictions provides information on entry requirements for people with HIV.

The US Centers for Disease Control also provides information for travellers. This includes required vaccinations and other precautions for specific regions.

Another site called Travel Health ONLINE provides individual health and safety information for over 200 countries as well as travel medicine providers.

Treatment tips

• Pack enough medication for your entire trip. Carry it with you in your hand luggage rather than in your suitcase
• Carry your prescriptions and a doctor’s letter with you. The letter should include the words: “These medications have been prescribed for a medical condition,” and a list of all the medications you are on. Keep the letter and prescriptions separate from your medications
• When changing your dose times to suit a new time zone do this gradually by moving the dose times slightly each time until they fall at more convenient times
• Use alarms, dosette boxes, etc. to remind you about dose times if you think you will have trouble remembering
• Ask your doctor, AIDS council or PLHIV organisation Treatments Officer for the details of HIV clinics in all the cities you are visiting