6 Things to Know About Traveling Abroad If You Have HIV
Traveling overseas can be risky for anyone, but if you have HIV, your concerns may be greater. A compromised immune system can increase your risk of contracting an opportunistic infection, so you may have to make more of an effort to safeguard your health. Also, some countries may present medical or legal barriers that directly affect you as an HIV-positive traveler. Here’s how to prepare before traveling abroad.
1. Find reputable travel information.
International travel has become so commonplace that we often underplay or entirely ignore the possible risks to our health. A 2009 study from the University of Wisconsin that examined a group of U.S. students studying abroad found that only 24 percent obtained prescriptions for travel-related medications before their departure, while less than half received the recommended vaccinations. More concerning, about 85 percent of study participants used travel guides as a primary source of health information, while only 60 percent used a doctor or clinic.
When planning a trip abroad, don’t rely on brochures, guides, or even travel agents to get the health information you need. The Centers for Disease Control and Prevention operates a comprehensive Travelers Health website, which provides HIV-specific information about the country you’re visiting. Choose your destination country and select “Immune-Compromised Travelers” to see a list of recommended vaccines and medications, as well as regularly updated travel advisories.
2. Familiarize yourself with the local laws.
While the majority of countries, including the United States, place no travel restrictions on visitors with HIV, there are some that do. Of these, eight countries technically bar entry to all HIV-positive people, while others impose restrictions for long-term visitors and immigrants.
When planning a trip abroad, start by identifying travel laws that might affect you as a person with HIV. The most up-to-date information can be found on The Global Database, a website managed by the International AIDS Society (IAS), European AIDS Treatment Group, and Deutsche AIDS-Hilfe.
“Even in countries that have no specific HIV immigration laws, there could be issues if your status is disclosed,” says Linda-Gail Bekker, MD, an infectious-diseases specialist and the president of the IAS. “It’s important to always speak with someone familiar with the laws — and the enforcement of the laws — before booking your ticket.”
Most advocates recommend that you call the embassy or consulate of the country you’re going to visit. These offices can often give you advice as to whether any laws have changed or whether any medical tests are required for short- or long-term visitors. Calls can be made anonymously, with no disclosure of your HIV status.
3. Visit your doctor well in advance.
When planning an overseas trip, make every effort to meet with your treating doctor at least four to six weeks before your departure. For a person living with HIV, “it’s important to consult with a specialist, who will not only know which vaccines you need but those you don’t,” says Dennis Sifris, MD, an HIV specialist based in South Africa. “Travel clinics can’t always make these calls, especially if they don’t have your medical history.”
As a rule of thumb, any vaccine made with a live virus (also known as a live attenuated vaccine) should be avoided by people with severely suppressed immune systems. While vaccines, like the yellow fever vaccine, can be used in healthier HIV-positive individuals, others, like the oral typhoid vaccine, should be avoided.
In countries where vaccinations are mandatory, a certificate of exemption may be issued by your doctor if you’re unable to be vaccinated for health reasons. Be aware, however, that this waiver may not be accepted in all countries and may carry information about your HIV status.
4. Check your health insurance.
Before traveling abroad, learn which medical services your health insurance will cover if you become ill while traveling. If coverage is provided, be sure to carry both your insurance ID card and one or more claim forms (which you can request from your insurer).
Also, be sure to ask whether your insurance company will pay the cost of medical evacuation if you need to be transported back to the United States. While many policies cover “customary and reasonable” hospital expenses, few provide payment for overseas evacuation — which can easily add up to tens of thousands of dollars.
The U.S. Bureau of Consulate Affairs maintains a database of insurance providers who can offer you short-term travel health coverage and medical evacuation services. They can also help direct you to recommended doctors and hospitals in your destination country, as well as the nearest U.S. embassy, consulate, or diplomatic mission in the event of an emergency.
It’s important to note that neither Medicaid nor Medicare pays for any medical costs incurred when you travel abroad. Seniors seeking travel health coverage can purchase a Medicare supplement plan (C through J), which includes a foreign travel emergency benefit for the first 60 days of a trip.
5. Pack smart.
Be sure to always pack your pills in your hand luggage, ideally in a sealed container well away from any liquids or gels that you may be carrying. Replacement drugs are usually difficult to obtain overseas, so bring extra doses — up to double the number you’d normally take for shorter trips — in case your return flight is delayed or pills are lost. And always be cognizant of time zones when traveling; discuss any changes in your dosing schedule with your doctor well in advance of your departure. Here are additional quick tips:
- Carry a prescription, a doctor’s letter, or an unsealed prescription bottle (with your name on the label) to minimize hassles at border control. This is not always necessary and doesn’t have to include any information about your HIV status. If asked, you can let customs officials know that your pills are simply medications for a chronic condition.
- If you’re traveling to areas where there are mosquito-borne diseases (like dengue fever, yellow fever, and malaria), pack ample supplies of insect repellent with a minimum of 30 percent DEET. Travel-size mosquito netting can also be purchased online.
- If you have to take an antimalaria drug, consult with your HIV specialist to ensure that it will not interfere with your antiretroviral medications. Therapies containing ritonavir, efavirenz, or nevirapine may require a dose adjustment if they’re taken with certain antimalarial drugs.
6. Watch what you eat.
If you’re traveling to a developing country, avoid any foods or drinks that might expose you to disease-causing bacteria or parasites. These include:
- Tap water or ice made from tap water
- Unpasteurized dairy products
- Raw or undercooked meat or street food
- Raw vegetables or fruit you haven’t peeled yourself
- Bottled drinks that haven’t been opened in front of you
- Any food from a street vendor
Overkill? Maybe. But the consequences of getting a water- or food-borne disease can be far greater in people living with HIV, so it’s always better to be safe than sorry.