Taking Trips and Traveling with HIV
Experts in infectious disease and public health have made
it clear that HIV does not pose a threat to public health in
relation to travel and mobility because the virus cannot
be transmitted simply by the presence of an HIV-positive
person or by casual contact.
As early as 1988, the World Health Organization (WHO)
stated that “since HIV infection is already present in every
region and in virtually every major city in the world, even
total exclusion of all travellers (foreigners and citizens
travelling abroad) cannot prevent the introduction and
spread of HIV.” It also said that since : “HIV screening of
international travellers would be ineffective, impractical
and wasteful… Rather than screening international
travellers, resources must be applied to preventing
HIV transmission among each population, based on
information and education, and with the support of
health and social services”.8 In that same year, the World
Health Assembly urged Member States “to protect the
human rights and dignity of HIV-infected people….and
to avoid discriminatory action against and stigmatization
of them in the provision of services, employment and
B. Travel Tips
-If you need to take your medications with food, come prepared: whether you're traveling by train, plane, or automobile, pack a few snacks. You'll also want to bring a bottle or two of water (or purchase one once you've passed through airport security).
Jet Setting: Meds and Time Zone Changes
You may need to adjust your medication schedule when you cross into a different time zone. Stephen Follansbee, M.D., suggests waiting 24 hours and then taking your next dose at your normal time, wherever you are. If you are a few hours off it shouldn't make a huge difference, he says. The most important thing is to stick to a regimen that's been working for you.
Playing it Safe
Take all of the same precautions you would at home to prevent HIV transmission. Bring a healthy supply of condoms if that's part of your safer sex practice -- they may be harder to find or of inferior quality in some travel spots.
Even though you may be able to buy many of these items during your trip, the peace of mind of having them at hand can be worth the extra bit of room they take up in your suitcase:
-antiemetics (to treat nausea or motion sickness)
Your doctor can recommend specific travelers' first-aid products that will not interact with your antiretroviral medications.
Managing Your Meds
As most people taking anti-HIV meds have learned from experience, no treatment regimen is completely free from side effects. These usually manifest within a few weeks after beginning treatment or making a switch, so it's smart to give yourself a solid month or two before wandering too far from home.
If your trip involves flying, pack as much of your medication in your carry-on bag as possible, since there is always a chance your luggage could be lost or delayed. According to the U.S. Transportation Security Administration (TSA) regulations, prescription and non-prescription medications do not need to be packaged in the usual quart-size clear plastic bag. If your medications are in liquid, gel, or aerosol form in containers greater than three ounces, you must declare them at the screening checkpoint (be sure to check the TSA Web site for updates. And if the name on your prescription label does not match the name on your passport or driver's license, be prepared to explain why to a security officer.
It's wise to count out your pills ahead of time, and to bring extras along in case you experience any delays or decide to extend your trip. If you're carrying any medicines that might be controlled substances (some pain medications, for instance), it's a good idea to keep them in their original containers with your prescription information attached. Carrying a letter from your doctor that states you are taking the drugs for a chronic medical condition can also be helpful. Regardless of where you go, bring a list of your medications, dosages, and dosing schedules, and your doctor's name and phone number. Always be prepared to replace your medicines, just in case. You may want to ask your doctor to give you extra copies of your prescriptions.
If any of your medications are temperature-sensitive, consider storing them in a small, insulated lunch bag with an artificial-ice freezer pack until you get to your destination. And make arrangements for a refrigerator where you'll be staying. Always read the manufacturer's guidelines and check with your doctor to confirm your options for storing medications.
So much of traveling is about sampling the local cuisine. Having HIV shouldn't prevent you from satiating your inner foodie. You'll just want to take a few extra precautions to keep yourself healthy.
Although the exotic smells from street vendors and outdoor markets may be tempting, it's often best to look rather than taste. Like most foreign travelers -- both HIV positive and negative -- you would be wise to steer clear of raw fruits and vegetables (which may retain unfamiliar microorganisms from soil or water), raw or undercooked seafood or meat (ground meats can be especially risky), and unpasteurized milk and dairy products. According to the CDC, foods that are generally safe include steaming-hot foods and fruits that you peel yourself.
Although eating food from a restaurant is usually your safest bet, be sensible about the foods you choose, especially in hotter climates where certain ingredients -- such as eggs and dairy products -- tend to spoil easily. Dr. Follansbee recalls a time when one of his patients who was visiting Cairo, and on his way to India to see the Taj Mahal, ate an egg-salad sandwich from his hotel restaurant. He ended up in a U.S. military hospital with severe food poisoning and shortly afterwards was on a plane back to the United States. It's better to err on the safe side than risk cutting your trip short.
If you're unsure about the local water supply, drink distilled water or bottled carbonated beverages -- without ice. (A bottle labeled "purified spring water" doesn't necessarily guarantee that it will be clear of Cryptosporidium parvum, one of the most common infecting agents in the severe diarrhea associated with HIV disease.) This is especially important when visiting developing countries where the water supply may contain microorganisms that pose little threat to local residents (who ingest them daily) but wreak havoc on the uninitiated stomachs of foreign visitors. If bottled water is not available, boil your water for at least one full minute before drinking it.
Medical Care and Insurance
If you're traveling to a remote area or developing country, Hudson (of Travel Zone) recommends calling your medical insurance plan to ask what it covers when you are away from home. Many insurance plans have limited benefits outside the home country. For example, the Medicare/Medicaid program does not cover medical services received abroad. Very few plans cover the cost of flying you home if you become very sick.
References for Traveling with HIV
Global Database on HIV-related Travel Restrictions
Joint United Nations Program on HIV/AIDS and International Organization for Migration (2004), UNAIDS/IOM Statement on HIV/AIDS-Related Travel Restrictions
International AIDS Society (2007), IAS Policy Paper – Banning Entry of People Living with HIV/AIDS
Ecumenical Advocacy Alliance (2008), Discrimination, Isolation, Denial: A Resource and Action Guide on Travel Restrictions against People Living with HIV
Gay Men’s Health Crisis – HIV Immigration and Travel Bar
Canadian HIV/AIDS Legal Network – Immigration and Travel
Global Health Council (2006), End Restrictions on Travel to the U.S. by People Living with HIV
Center for Strategic and International Studies (2007), Moving Beyond the U.S. Government Policy of Inadmissibility of HIV-Infected Noncitizens
Office of the United Nations High Commissioner for Human Rights and the Joint United Nations Program on HIV/AIDS (2006), International Guidelines on HIV/AIDS and Human Rights