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Traveling When You Are HIV+

Sometimes people living with HIV are told they should not travel, because it would be bad for their health. However, looking at some of the risks and immediately it becomes evident that these risks are not unique to people living with HIV:
You might get diarrhea!
You might get malaria!
You might get typhoid!
You might get sunburnt, tired, drunk!
For people living with HIV, there is no reason not to travel as long as they are in good health and take some extra precautions.

It’s all in the Preparation: Pre-trip Planning

See Your Doctor
Before you book any tickets or part with any money, and well before your planned departure date, speak to your doctor. Discuss your plans in detail, so your doctor can help you decide if they are realistic, taking into account your medical condition and fitness. If you are asymptomatic from the HIV point of view (you're not sick) and have a CD4 count above 500, you should have no special problems with traveling.

If you have medical problems, have a low CD4 count, are easily tired or unfit, your doctor can help you decide if you are up to your planned trip, or whether it can be changed to make it more comfortable for you. Your doctor can also explain in more detail, the risk and benefits of travel vaccines and which ones are recommended and safe for you.

Plan Your Medication

Your doctor can give you information on managing your regular medication while you're away. You'll need to take enough supplies, and keep them in your hand luggage. If you change to a different time zone, you'll have to adjust your daily medicine schedule. Your doctor can advise to you make that adjustment as safe as possible without risking problems with your medicines.
Carry enough of your regular medication to last the trip plus an extra few days in case of delays. Medication should be carried in hand luggage since checked-in luggage may get lost or misplaced. Keep medicines in their original containers and carry a letter from your doctor explaining that they are medications prescribed for you.

Store medicines carefully. Many deteriorate in hot, humid conditions so store in a cool, dry place. Follow the advice of your doctor. Carry a snack and a drink, especially if you need to eat with your medications.

If you are using intravenous medication, e.g. gancyclovir for CMV retinifis, you can still travel. Ask your doctor for details on transport, storage, and administration of your drugs well in advance of your trip.

It may also be a good idea to carry:

• A letter describing all the drugs you are taking and a brief summary of your medical history
• A contact phone number for your clinic, and advice on what to do if you require emergency treatment while abroad.

Traveling with Medications

Antiviral Therapy Medications
Combination antiretroviral therapy (ART) regimens may involve a number of different medications and a complex schedule, with the necessity to eat at certain times and to drink extra fluids in some cases.

To maintain the benefits of therapy and avoid the mergence of resistant strains of the virus, it is just as important to stick to your regimen when traveling as it is when you are at home. This may be difficult especially if traveling across time zones. Discuss this with your doctor, who may recommend the use of pocket charts, compartmentalized pill boxes, timers etc. to help you stick to your schedule.

Emergency Medication
Your doctor may suggest that you take antibiotics with you in case of a chest infection, diarrhea or a urinary tract infection. It may also be wise to take some anti fungal medication if you are prone to thrush, especially if it tends to occur after antibiotics.

Medication to control diarrhea can be helpful but should be used carefully (follow instructions). It can make the difference between a vacation ruined by frequent trips to the toilet, and being able to get on with your normal activities. It is advisable to take a rehydrating agent for use if you have persistent watery diarrhea. Tablets or powder can be bought cheaply over the counter.

Anti Malarial Drugs
Malaria is a potentially life threatening disease common in certain parts of the world, which is largely preventable by using preventative medications and avoiding insect bites. You should ask your doctor if anti malaria prophylaxis is recommended for the area you are visiting. Anti-malarial medications usually should be started the day before arrival in the "malaria zone", and continued until 4 weeks after return.

If you get a high fever or flu-like symptoms you should still check with a (local) doctor because despite prophylactic medicines you could still get malaria (although usually milder, it could still be potentially dangerous, so you'll need treatment).

Entry Restrictions
As of mid-2012, there are still 45+ countries, territories and areas around the world that continue to employ some form of restriction on the entry, stay and residence of people living with HIV. Fortunately, momentum to remove these restrictions persists and there is pressure on the remaining governments to change their policy.

Very few countries have restrictions for those intending to stay in the country for less than three months, so people living with HIV who wish to take a vacation do not usually have any problems.
In case of doubt, call the embassy of the country you want to visit to get the most up-to-date information before you book your trip.

The website http://plwha.org  provides good tips on traveling for PLWHA.

Insurance
Every traveler is advised to have comprehensive travel insurance. It should cover the cost of all treatment you might need while away, including the cost of medication, and if possible should also cover the cost of flying you home with a doctor, should this become necessary.

It is very important to check the small print very carefully on any policy you may be considering. Some policies will not cover HIV-related illness, while others may not cover any medical problem, including accidents, in people who are HIV positive.

Many people with HIV who travel feel that the best insurance policy is sufficient funds, either in cash, travelers’ checks or a credit card, to get straight on a plane and come home, if they become ill.

In any case, you should have money available to pay for treatment as you receive it, as many insurance policies will not pay "up front" but will reimburse you on your return home.