Travelling, whether for business or pleasure, can often be stressful and HIV can often add complications. Industry expert, Lee Nicholson, gives us some helpful advice…
Getting ready to go
It is always be a good idea to talk to your HIV team at your clinic. This is going to be particularly important if you are jetting off to somewhere where there is a large time zone difference with the UK. If you are making a very long trip and have certain, specific, health issues such as a very low CD4 count, you should definitely check with your consultant if you are fit and safe to travel.
Depending on where you are travelling to, it’s quite probable that you will have to consider adjusting the timing of any meds you are taking, to take into account the time zone of the place you are visiting – including stop-overs. This should be done in advance of travel. Some people prefer to still take their meds at the normal time they would in the UK, i.e, with a 12 hour time difference… taking usually morning meds in the evening and vice-versa.
This doesn’t work so well if the time difference means you’ll be sleeping when you normally take your meds. It may be best to work out a way of staggering the taking of your meds before departure by an hour each time a dose is taken until the timings are suitable for your arrival
If you are heading to a place with restrictions on HIV, do spare a thought for how would deal with being denied entry or potentially having your medication taken away. This can be extremely stressful, and the consequences of a forced treatment break could be harmful. You should check out the restrictions, rules and regulations applicable to your destination online before you book or travel. One such resource is: http://www.hivtravel.org/ Several countries require you to produce the result of an HIV antibody test before they will issue a visa for travel, and many countries still retain the right to refuse entry to travellers who are HIV positive.
HIV treatments aren’t free from side effects. If you are starting a new treatment or combination, make sure any side effects are
manageable before you travel. Make sure you carry any anti-sickness or anti-diarrhoea meds as necessary. Your doctor will know if there are any special vaccinations you may need and which ones are safe for you to get, taking into account your HIV status and treatment regiment when organising this. Some countries insist that you have a Yellow Fever vaccination certificate if you have previously travelled to an infected area so please speak to your doctor about this or go to a travel clinic.
When you start packing for your trip, it is best to carry medication in your hand baggage, as checked in luggage sometimes becomes delayed or lost. Always keep the medication in the original packaging, and take more than enough medication for your trip. I would suggest enough for the trip, and an extra week’s worth at least in case you stuck or your travel plans need to change. On the flip side of this it’s best not to take a mass excessive quantity of medication – airport officials, and especially immigration officers in the USA may consider this a intention to overstay your permitted entry conditions.
Another option for you to consider is sending your medication ahead of travel. It is important to check that it has arrived at your destination before you leave and it has not been damaged while being transported.
At airport security there are restrictions on carry on liquid amounts. You are not allowed to take any liquids through security that are over
100ml. If you are intending to carry any liquid medication exceeding this amount, in your hand luggage for the aircraft cabin, you would
have to declare it to the security officers.
Needles are prohibited items in general, but are allowed for medical use. You would always be required to produce documentation, i.e a letter from a Dr to support your medical use of it on a flight – the cabin crew may ask to see it. Commercial airlines carry sharps boxes for use in these circumstances. It would be advisable to contact the airline prior to departure if you intend to inject on the flight, just so there is no fuss when you are in the air. You should never need to disclose, just advise you will be injecting yourself with essential medication.
The immigration officers will only be checking your passports and visas, as they do with everyone. There should be no requirement for any searches or questions, unless the officer has any suspicions about your entry into the country, i.e if they think you may be intending to outstay your welcome or similar.
When you pass through immigration to customs, the customs officers in most countries would require prescription medication to be
accompanied by a letter for the prescriber that would explain the purpose of the medication. This applies to all drugs not just HIV meds. Some people carry a letter from their doctor stating that the medicines are for a chronic illness, but not explicitly stating it is HIV. They also ensure that no labels make it clear what the medication is for. If you have sourced and prepared this documentation prior to travel there would be no reason for any fuss should you be stopped.
If you are stopped, remember you will always have the right to be searched on your own and this doesn’t have to be in front of others. Request a private room if this makes you feel more comfortable. If you are travelling to place with restrictions for HIV positive travellers, this is the place where you will likely be ‘discovered’. If they discover you are lying they will probably refuse entry and deport you.
When you are there…
Once at your destination there are a few sensible health precautions you can take to minimise the risk of becoming ill. Food and drink can
sometimes be a source of infection abroad, most often in developing countries. Only drink water that has been boiled, bottled water, and
avoid ice unless you are sure it has been made with boiled water. Food bought from street vendors should be avoided, as should raw seafood
and other raw foods (except fruit and vegetables which you have peeled yourself).
Don’t forget that potentially some medication can increase your sensitivity to the sun, so we recommend you use a high factor sun tan lotion.
Be a step ahead and think about adherence to your medication. It can be easier or more difficult whist travelling. Jet lag causes tiredness and fatigue, and potentially can affect your short term memory.If you are not taking your medication when you normally would and should, you could set an alarm.
If you are travelling to somewhere with a different climate make sure you store any meds in accordance with their specific guidelines. Some meds may be required to be kept cool. Check with your HIV clinic and pharmacy.
If you plan to have sex while you are on holiday then take your own supply of contraception. Not all countries provide as easy access to
them as the UK and quality standards may not be as high.
It’s always possible for silly things to affect our travel plans – strikes and bad weather constantly prove challenging in our line of work. Remember the volcanic ash cloud that grounded flights for nearly a month? Things like this could potentially affect you should you start to run out of medication. Your clinic & consultant in the UK will be able to provide a letter by email or fax, detailing what you need. Documentation, whether prepared before travel or sourced after is particularly important when it comes to the correct dosages of what you take. Bear in mind that some brand names differ in different parts of the World, e.g ‘Eviplera’ in the UK is called ‘Complera’ in the USA.
NHS prescriptions are not valid abroad so you would probably need to see a local doctor to get a new prescription. In some countries it may be possible to buy anti-retrovirals without prescription over the counter, in this case you must beware of counterfeit medications
A good lesson FOR ALL is the clear importance of having good travel insurance.
Lee Nicholson is an experienced Aviation Safety professional at a UK charter airline. He has extensive experience of training delivery to a multi-cultural and diverse workforce, and is a advisor on Aviation & Travel Safety.
You can follow him on twitter as @ldnncl