TRAVEL HEALTH ADVICE FOR PEOPLE WITH HIV AND AIDS

Sometimes people living with HIV are told they should not travel, because it would be bad for their health
YOU MIGHT GET DIARRHOEA!
YOU MIGHT GET MALARIA!
YOU MIGHT GET TYPHOID, TIRED, SUNBURNT, DRUNK
YOU CAN'T GET INSURANCE!
THEY WONT LET YOU IN!

But off course anyone likes to travel, and you should if you want to. Maybe you might have to take some extra precautions, and sometimes it has some risks, but mostly it is safe to go on trips. Travel is good for you. It is life enhancing. It's worth it!

It is possible to travel safely, reduce the health risks, and enjoy yourself. These pages can help to give you some basic information. If in doubt, discuss them with your doctor.

It's all in the Preparation Pre-trip Planning
Have you always dreamed of trekking in Nepal, white water rafting down the Zambezi or viewing big game in Zimbabwe? Or do you want to Carnival in Rio, float down the Nile, survive New York or just sit on a beach in Spain? When you have decided where you want to go, when you want to go and what you want to do when you get there, the next step is to get information.

Speak to people who have already been there, read guide books, phone travel agents. Find out as much as you can about the country, the climate, the people, the culture, the weather, the health service, the food and the accommodation.

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.

Checklist to ask your doctor for:

Advice on vaccinations
Advice on anti malarial drugs (if you need them)

Information on managing your regular medication while you're away. You'll need to take enough supplies, and keep them in you 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.

If appropriate, carry a supply of medication to:

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.

Entry Restrictions
Some countries impose entry restrictions on travelers, based on their HIV status. Very few countries have any restrictions for those intending to stay in the country for less than three months, so holiday makers 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.

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 be 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.

Traveling With Medication
Antiviral Therapy
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 clinic doctor, who may recommend the use of pocket charts, compartmentalized pill boxes, timers etc. to help you stick to your schedule.

Checklist Medication
Make sure you have enough medication to last until you can attend the clinic again. (At least duration of flight plus one week after return). Carry medication in hand luggage. (Hold luggage may get lost easier). Keep medicines in their original containers whenever possible 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. Some medicines must be stored in the fridge even during long flights. Follow the advice of your clinic. Carry a snack and a drink, especially if you need to eat with your medications.

If you are using intra venous 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.

"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 holiday 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, still potentially dangerous, so you'll need treatment).

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