Country restrictions

Country restrictions

In the case of a country with entry bar, can I legally enter if I have HIV?

The short answer is “no”. However, an entry bar is close to impossible
to strictly enforce at any port of entry. What are people doing to enter
such countries anyway?

As long a visitor has no visible symptoms of illness and/or no
antiretrovirals to take, this is not very difficult. For people on
treatment however, the question becomes tricky.

As we have seen in the case of the United States former entry
restrictions, people on ARVs use certain ‘crafty’ strategies to
circumvent entry bar regulations. We do not legally recommend any of those.

We try to describe a country’s policies and how they might apply in
various circumstances, and then let the reader make their own decisions
about what to do.

It might well be that some of the bypassing strategies below constitute a
violation of applicable immigration laws or other local laws. We do not
know what the consequences of such violations might be. It could be
that they result in a permanent ban on entering the respective country.
However, that might not make a significant difference to an HIV positive
traveller, since once they are found out, they are found out and barred
from re-entry anyway.

1. The safest strategy

  • Rebottle medications with non-prescription packaging
  • Carry a letter from a clinician

Rebottle the medication in neutral packaging and make sure it is
properly labelled by your pharmacy (this means without mentioning the
nature or brand name of the drugs). To comply with laws in many
countries, you are recommended to carry a letter from a clinician which
states that your drugs are prescribed for a personal medical condition.
This letter should not mention HIV. Be ready to answer questions about
why you need these drugs without hesitation (blood pressure, coronary
problems, etc.).

Risk:
Small, especially with today’s therapies (reduced number of pills). Plan well ahead to have everything ready.

Advice:
You should carry the drugs in your hand luggage. Checked luggage is
sometimes late or can get lost completely. However, be aware that the
drugs can be detected more easily that way.

2. Carry your drugs on you, or in your luggage

This is what most people do.

Risk:
There is a certain risk of being detected by immigration officials or by
customs. If this happens, you may face deportation on the next
available flight. As a consequence, there is likely no chance of being
readmitted to enter the respective country at a later occasion.

Advice:

  • HIV-positives are advised to take enough medication to cover delays.
  • To comply with the law in many countries, you need to carry a
    letter from a clinician which states that your drugs are prescribed for a
    personal medical condition. This letter should not mention HIV. Be
    ready to answer questions about why you need these meds without
    hesitation (blood pressure, coronary problems, etc.).
  • You should carry the drugs in your hand luggage. Checked luggage
    is sometimes late or can get lost completely. However, be aware that
    the drugs can be detected more easily that way.
  • Leaving a country with remaining ARVs in the hand luggage is also not free of risk.
  • Take a last dose to be safe during travel. Before checking in,
    eliminate remaining meds and ensure to have drugs available when needed
    after arrival. However, there is a small risk in case of delayed
    departure.

3. Buy your antiretroviral drugs locally

This looks simple, but also needs some planning.

  • Contact your health insurance to find out if drugs you purchase
    locally are reimbursed (medication, including antiretrovirals, can be
    more expensive locally than in your home country).
  • Check with local contacts if your regimen is available in the pharmacies of your destination country.
  • Get a prescription for the medication you are taking from your doctor.
  • Take a last dose of your meds before leaving the plane.
  • Get an appointment with an HIV specialist on arrival to get a prescription.
  • Buy your drugs through a local pharmacy.

4. Considerations before stopping medication

As the Brighton study has demonstrated, some people decided to interrupt
treatment before travelling to the US (note: this refers to the past,
when the U.S. entry ban was still in place). THIS CAN BE VERY RISKY.

If you are thinking of stopping your medications when travelling to a
country with an entry bar, it is imperative that you consult with either
your HIV clinician or pharmacist well ahead before doing so, otherwise
you run the risk of acquiring new or further resistance that could have
significant future health risks. Remember also that if you do stop HAART
that you may feel ill during your trip, and that you may also be more
infectious.

IMPORTANT: Never discuss your HIV status with local officials!
The country that people with HIV had the most problems with in the past
were the United States. However, we also had reports from people being
sent back from China, another country that has recently changed its
entry policies.
There are more things you can do in order to avoid running into problems.

  • Do not disclose your status to fellow passengers.
  • Be careful of outing yourself by wearing a red ribbon.
  • Avoid disclosing your status to customs or immigration officers. It is not their business.
  • If you are asked why you are carrying medications, have a good excuse ready.

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