Travelling with HIV

Question:

I am going on vacation. What precautions should I take because I am HIV-positive?

The essentials:

You should consult with your doctor to get a check-up about one month in advance of your departure. Discuss the specifics of your trip: itinerary, location, length of stay and facilities. Your doctor should be able to tell you whether there are any specific medical concerns, and what precautions and/or preparations may be necessary. You may want to get a medical report to take with you in case you need medical care.

Do not start any new treatments within a month of departure, especially if the treatment poses a risk of an allergic reaction (e.g., Viramune, Sustiva, Ziagen, Trizivir or Bactrim).

Some countries have travel restrictions on people with HIV: find out before you go.

More details:

Vaccinations

Vaccinations are sometimes recommended before travel if there is a risk of local diseases. Find out which vaccinations are recommended for the particular place(s) you are going to. For most vaccines, if your CD4 count is over 200, recommendations are the same as for people who are HIV negative.

The following vaccines are recommended for all people who are HIV positive, regardless of travel: pneumonia, flu, diphtheria, tetanus, and hepatitis A and B.

However, some vaccines, particularly “live” vaccines, are not recommended for people with HIV. “Inactivated” or “attenuated” versions should be used instead: this includes vaccines for polio and typhoid fever.

Some vaccines (yellow fever) are only available as live vaccines. It is not known whether the risk of using these outweighs the risk of the disease itself. If travelling to a risk area for these diseases, you should discuss these vaccinations with your doctor.

Other diseases

If travelling to an area at risk for malaria, an anti malarial prophylaxis is recommended. Check for drug interactions: atovaquone lowers the blood levels of indinavir (Crixivan).

Travel pharmacy

Plan to bring enough of your medications for your entire trip, with some to spare. If travelling to a different time zone, plan how you’ll adjust your medication schedule.

Some medications that are useful to bring on trips include:

  • Medication for fever or pain: ibuprofen (Advil) or acetaminophen (Tylenol)
  • Anti-diarrheal medication: Imodium or Lomotil
  • Antacids (e.g. Maalox). These may need to be taken two hours apart from certain HIV meds
  • Anti-nausea drugs: (e.g. Gravol)
  • Anti-allergics (e.g. Reactine)
  • A wide-spectrum antibiotic, to be decided with your doctor prior to departure.
  • Basic first-aid supplies, including antiseptics
ATTENTION:
Read the warnings concerning your medications. Some medications cannot be stored in heat. If you are traveling in an area that is hot, plan to bring a cooler or a cold pack, and get a refrigerator in your room. Some meds (e.g. Septra) can cause greater sensitivity to the sun, so cover up and bring sunscreen.

Key terms to know:

CD4 count – The number of infection-fighting “CD4 cells” in a cubic millimetre of blood.
prophylaxis – Preventative medical treatment.

Some useful resources from other websites: