HIV and travel

Image: Domizia Salusest | www.domiziasalusest.com

Key points

  • Make sure you pack enough of your anti-HIV drugs to cover your trip.
  • Some live vaccinations are not appropriate for people with HIV.
  • Some countries refuse work or residency visas to people living with HIV.

Many people living with HIV travel regularly for work, business, study, and for pleasure. In most cases, HIV is not a barrier to travel and holidays. This page provides an introduction to some of the issues you may want to think about if you are planning to travel.

As for other long-term health conditions, it is sensible to consider your health and medication when you make your travel plans. At the most basic level, consider if you are well enough to undertake the trip you are planning.

People living with HIV are able to travel to most countries of the world. But some countries have restrictions on entry for people with HIV, most often for people applying for a work or resident’s visa. See Travel restrictions below.

Also, find out if you need any vaccinations or other preventive medicines, and if it is safe for you to have them. What vaccinations you might need depends on where you are travelling to. If you are accessing travel vaccinations through your GP, it is important that they know you have HIV so they can give you the most appropriate care. It’s also important your GP knows about all the drugs (including anti-HIV drugs) you are taking, in case there are any possible interactions with drugs you might be given for travelling, such as anti-malarials or antibiotics. People with HIV are recommended to avoid some live vaccinations. Find out more on our page on the recommended vaccinations for people living with HIV.

Travelling with HIV treatment

It might be very difficult, or even impossible, to get supplies of your medication once you’ve left home – even if you are just taking a short trip in the UK or Europe. Therefore, make sure you take enough of all your medicines with you to last the full duration of your trip. It might be wise to count out your medicines before you travel and to take a few additional doses just in case you are delayed.

It’s safest to carry your medication in your hand luggage, as this is less likely to get lost. Or you may choose to put some in your hand luggage and some in your suitcase, in case either bag is lost. If you are travelling to another country it makes good sense to have a copy of your prescription or a letter from your doctor explaining that your medicines are for a chronic medical condition. Find out more on our page on travelling with HIV medication.

Temporarily switching to injectable HIV treatment

If you feel uncomfortable about travelling with your HIV medication or are concerned about entry restrictions for people with HIV, one option might be take injectable HIV treatment. Depending on what is available where you are, your doctor may be able to provide an injection which will cover you for the duration of your trip. You may need to switch back to daily tablets when you return.

At the time of writing, the only complete HIV treatment provided by long-acting injections is a combination of cabotegravir and rilpivirine. In Europe, the brand name for injectable cabotegravir is Vocabria, while the brand name for injectable rilpivirine is Rekambys. In North America and Australia, the two drugs are packaged together, with the brand name of Cabenuva.

The injections can be taken either once a month or every two months. They would not suitable for a trip of longer than two months. For more information, see our page on cabotegravir and rilpivirine injections.

Treatment breaks

Treatment breaks are not recommended. If you are thinking of taking a break from your HIV treatment to travel, then you should discuss the possible risks of this with your doctor. These risks include developing resistance to your drugs, being more vulnerable to health problems in the future and – if you have a low CD4 cell count – of becoming ill while you are not taking treatment.

Timing your doses

If you are travelling across time zones, this will have implications for the time you take your medication. Generally, it’s best to adapt to the time zone of your destination as quickly as possible – if you usually take medication with breakfast at home, you should take it with breakfast during your trip. Keeping the same routines around pill taking will probably help your adherence.

Glossary

undetectable viral load

A level of viral load that is too low to be picked up by the particular viral load test being used or below an agreed threshold (such as 50 copies/ml or 200 copies/ml). An undetectable viral load is the first goal of antiretroviral therapy.

viral load

Measurement of the amount of virus in a blood sample, reported as number of HIV RNA copies per milliliter of blood plasma. Viral load is an important indicator of HIV progression and of how well treatment is working. 

 

resistance

A drug-resistant HIV strain is one which is less susceptible to the effects of one or more anti-HIV drugs because of an accumulation of HIV mutations in its genotype. Resistance can be the result of a poor adherence to treatment or of transmission of an already resistant virus.

chronic infection

When somebody has had an infection for at least six months. See also ‘acute infection’.

adherence

The act of taking a treatment exactly as prescribed. This involves not missing doses, taking doses at the right time, taking the correct amount, and following any instructions about food.

If you are stable on treatment with an undetectable viral load, then taking one dose of your drugs a few hours early or late, because of a change in time zones, will not usually cause problems. You can get more detailed advice on our page on travelling with HIV medications. You can also ask for help from your doctor or pharmacist.

Accessing medical treatment away from home

If you live in the UK and are travelling elsewhere in the country, you should contact the nearest accident and emergency department if you need emergency care. You can be seen by a GP away from home as a ‘temporary resident’ if your trip is for under two weeks. If you are entitled to free NHS care, you can get this anywhere in the UK.

The UK has agreements with some countries allowing for free or reduced cost medical care that a person may need.  This includes members of the European Union, Australia and New Zealand, but there are restrictions on the types of medical treatment that are covered. UK residents should carry a Global Health Insurance Card (GHIC) when travelling.

It may also be wise to consider taking out travel insurance. Most policies specifically exclude treatment for a pre-existing medical condition (this would include HIV), but will still provide cover if you have an accident or become ill with something unrelated to HIV. Some companies provide travel insurance cover that includes HIV. You can get more detailed information on our page on travel insurance.

Travel restrictions

A number of countries restrict entry for people with HIV. This means that foreigners with HIV may be refused entry, denied permission to work or settle, or even be deported.

A few countries ban all foreign HIV-positive individuals from entering a country; others have no entry restrictions for tourists but require individuals to be HIV negative in order to apply for a work or residence permit. There's more detailed information on our page on travel restrictions.

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