Travelling with HIV medication

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Key points

  • Carry your medication in a carry-on bag and bring a letter from your doctor explaining why you need it.
  • Be aware of any restrictions on HIV medication in the country you’re visiting.
  • You may need to adjust the times you take your medication when you change time zones.

This page provides information about travelling abroad with HIV medication.

Packing your HIV medication

When you’re travelling, you should take all the HIV medication that you need to last the whole trip, plus extra to allow for delays.

If you’re taking prescription medication abroad you should also take documentation for the medication. This is usually a letter from the doctor who prescribed your medication which explains that you need it for your trip. The letter does not need to mention HIV. It just needs to explain that the medicines are being carried for a chronic (long-term) medical condition and that they are for personal use.

The letter should list your medications, including their brand names, their ingredients, the amount you take, and how often you take them. Make sure it also includes your name, date of birth, and address. It can be helpful if it’s written on headed paper from your HIV clinic, hospital, or doctor’s surgery.

If you’re comfortable discussing your HIV status and there aren’t any restrictions for people with HIV entering the country you are travelling to (or through) it may help to mention HIV in the letter. This can sometimes help to speed up any questioning by customs or border officials.

Carry your HIV medication and its documentation in a carry-on bag (hand baggage). This helps to avoid problems if your checked baggage is delayed or goes missing. You could also consider carrying a full dose in your carry-on bag and another in your checked baggage. This means you’ll have your medication if either bag goes missing.

There is more advice on the British HIV Association website.

Restrictions on travelling with HIV medication

If a country has entry restrictions for people with HIV, being found with HIV medication might mean you are deported (made to leave the country). A few countries ban all foreign HIV-positive people from entering a country. Others have no entry restrictions for tourists but require people to be HIV negative if they apply for a work or residence permit. There’s more information on travel restrictions on another page.

Getting HIV medication abroad

Some people try to avoid carrying medications through borders and try to use other ways to get access to medication once they’ve arrived. This can lead to difficulties.

Posting medication to a friend in another country can cause problems because it may get lost or delayed. Most countries have restrictions on medicines that you can send or take in, so check with the country’s embassy, consulate or High Commission. Postal companies also have rules about sending medicines and the contents of your parcel could be inspected by customs.

Getting medication abroad may also be difficult. The medicine you need may not be available or it could be very expensive. It can often be very difficult, or even impossible, to get prescribed HIV medication in a foreign country.

Can I take a break from my HIV medication?

Treatment breaks are not recommended. If you are thinking of taking a break from your HIV treatment when you travel, then you should discuss the risks of this with your doctor.

These risks include developing resistance to your drugs and being more vulnerable to health problems in the future. If you have a low CD4 cell count it can also mean you risk becoming ill while you are not taking treatment.

Time zone changes and HIV medication

If you’re taking a long flight and travelling across time zones this will affect the time you take your medication. If you have an undetectable viral load, then a single dose taken a few hours earlier or later than usual will not usually cause problems. However, you should speak to your doctor or pharmacist if:

  • your viral load is not fully suppressed
  • you have HIV which is resistant to some of the drugs you are taking
  • you have complex travel plans with lots of time zone changes within a few days
  • you are going on a journey lasting more than 24 hours, for example from the UK to Australia.

If it’s safe to do so, it’s generally recommended that you avoid taking a dose of medication on the plane. This is because during a flight it can be even more confusing to work out time zone changes and mealtimes.

Glossary

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.

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. 

 

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.

association

An association means that there is a statistical relationship between two variables. For example, when A increases, B increases. An association means that the two variables change together, but it doesn't necessarily mean that A causes B. The relationship isn't necessarily causal.

anxiety

A feeling of unease, such as worry or fear, which can be mild or severe. Anxiety disorders are conditions in which anxiety dominates a person’s life or is experienced in particular situations.

However, there are some situations where you might have to take a dose of medication on the plane. This could be because you have HIV which is resistant to some of the drugs you are taking and you can’t delay a dose. Or it might be that your travel plans are quite complicated or that you’re going on a very long journey.

If your medication comes with instructions about food (for example, it has to be taken with a meal), these still need to be followed when you’re travelling.

Once-a-day medication

The following advice applies to most modern anti-HIV drugs which are taken once a day. It’s aimed at people doing longer journeys that are more than eight hours long. 

  • On the day you leave, delay your dose until a few hours before your flight.
  • Take another dose when you arrive.
  • Take the next dose at your usual time, but in the local time of your destination. For example, if you usually take your medication with breakfast at home, you should take it with breakfast during your trip.

In practice, this means that if you usually take your medication in the morning and you were taking a long evening flight, you wouldn’t take your pills in the morning. Instead, you would take them during the afternoon or early evening. Then you would take another dose just before or after the plane lands. The next time it’s morning in the country you are in, take your dose as usual.

If you’re taking efavirenz or Atripla, you might sometimes experience side effects such as anxiety or mood changes. If you want to avoid these while you’re in the airport or on your flight try to avoid taking a dose just before you leave. You can safely delay taking your medication for a few hours.

Twice-a-day medication

This advice applies to modern anti-HIV drugs which are taken twice a day. You may need to take an extra dose during long flights.

  • On the day you leave, delay your dose until a few hours before the flight.
  • If the flight is longer than twelve hours, take another dose at a convenient time during the flight.
  • Take another dose when you arrive.
  • Take the following dose at your usual time, but at the local time of your destination.
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