HIVTravel - Travel tips

Travel tips

General information for HIV-positive travellers and tourists

The following are some tips to consider when travelling as a tourist or on business trips with antiretroviral medication.

Always carry your medication in your hand luggage. Checked luggage might get lost or delayed. • Always take some days of extra medication with you. You might not return as planned, for unforeseeable reasons. It is cumbersome to run after expensive prescription medication in a different country, and you might not even receive the drugs you are taking if in need.
You may have to check specific customs regulation for importing your medication. In almost all cases, importing medicines for personal use would not pose a problem. To be on the safe side, carry a doctor’s prescription in English with you. The prescription should make no mention of HIV.
Carry your medication in original packaging, labelled with your name.
Do not disclose your HIV status unnecessarily. Not to other travellers, not to customs or immigration officials – it is not their business. Be aware that people with HIV are stigmatised in many countries.
If you stay in a country for a longer period, or if your health is frail, make sure you know where the next HIV clinic is, or get the address of a clinician specialised in HIV. It might be a good idea to get in touch with a local HIV organisation.
People taking substitution treatment: check about specific regulations in this respect before travelling. Some countries consider substitution treatment as illicit drug use.

Most important: be aware that perceptions around HIV infection change from country to country. So if disclosure is safe in the country and community you normally live in, this might not be the case in the country you are visiting.

Updated: January 26, 2011

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.

Updated: January 26, 2011