If you’re HIV-positive and planning to travel outside the U.S., you may face health risks you don’t have at home. Here’s what you need to know to help you stay safe while abroad.
Why Am I at Increased Risk When Traveling Overseas?
All international travelers need to be aware of health risks in the areas they’re visiting. If you have HIV, this is especially important. That’s because a weakened immune system can increase your risk for opportunistic infections. These illnesses are more common and can be more severe if you have HIV.
The risk is greatest for opportunistic infections if your CD4 cell count is less than 200 per cubic millimeter or if you’ve had an AIDS-related illness. CD4 cells, also known as T cells, are your infection-fighting white blood cells. Your CD4 cell count is a good sign of the health of your immune system.
What Should I Do Before My Trip?
When visiting other countries, especially developing countries, it’s important to plan ahead.
Visit your doctor. Make an appointment to see your doctor 4-6 weeks before your trip, if possible. Make sure you’re up to date on your routine vaccines, including those for COVID-19, influenza, and hepatitis A and B. Also ask about any special precautions you should take based on the health risks found in the areas you’ll be visiting.
For a list of necessary health precautions listed by country, check the CDC’s website. If your doctor is unable to advise you, look for a travel medicine clinic. Health care providers at these clinics specialize in the health needs of travelers.
Your doctor or travel medicine specialist also may be able to give you the names of clinics or doctors who treat HIV in the areas you’ll be visiting in case you need care while away from home.
Review your health insurance. Check your policy to see what’s covered when you’re traveling outside the U.S. If your coverage doesn’t include emergency medical evacuations or medical care in another country, you may want to buy additional travel insurance.
Be sure to take proof of insurance on your trip. It’s a good idea to scan your policy and email it to yourself so you can access it while traveling. Also leave a copy of the policy in a safe place at your home and tell a family member or friend where it is.
Learn about travel restrictions. Some countries do not allow entry to people with HIV or limit their length of stay. In more than 70 countries, same-sex relations are considered a crime and may carry severe penalties. To review the laws, policies, and practices in the countries on your travel itinerary, check the State Department’s website.
When you meet with your doctor or travel health specialist, be sure to discuss these precautions:
Travel vaccines. Depending on your destination, you may need to be vaccinated against diseases that are found in other countries. If you are traveling to a developing country, you’ll want a typhoid fever vaccine. If you have HIV, you should receive the inactivated (injectable) vaccine, not the live virus (oral) vaccine. Depending on the destination, yellow fever vaccination may be required, but this is a live virus vaccine and you should not get it if you have HIV. Rather, a waiver should be obtained to show immigration authorities in the country you are traveling to.
If possible, give yourself at least a month to get travel vaccines. That way, you’ll have the best chance of having full protection. If you don’t have that much advance notice, ask your health care provider if you can get the necessary vaccines quicker.
Medicines you may need. Make sure to bring enough of your HIV medicine, and any other medicines you take, to last throughout the period of travel. These should be packed in carry-on luggage so as not to risk loss in checked baggage.
No matter where you travel, you can get sick with travelers’ diarrhea. But your risk is highest in Asia (except for Japan and South Korea), the Middle East, Africa, Mexico, and Central and South America. As a precaution, your doctor may prescribe a 3-7 day supply of medicine that you can use if you get travelers’ diarrhea.
Malaria is an insect-borne disease that can cause serious illness, especially if you have a weakened immune system. If you’re traveling to an area where malaria is common, you may need to take preventative medicine for several weeks before and after your trip. Malaria mostly occurs in tropical and subtropical areas, including Africa.
What Precautions Should I Take During My Trip?
Once you reach your destination, take the following steps to help you stay safe:
Be careful with what you eat and drink. When traveling, you’re at higher risk for foodborne and waterborne illnesses than you are at home. To help protect yourself, do not:
- Eat fruit or vegetables you haven’t peeled yourself.
- Eat unpasteurized dairy products.
- Eat uncooked or raw meat or seafood.
- Eat any food from a street vendor.
- Drink plain tap water or drinks or ice made from tap water.
When eating or drinking, choose:
- Hot foods
- Fruits that you peel yourself
- Hot coffee or tea
- Bottled water and drinks with the seals intact
- Water that’s been boiled for 1 minute, then cooled in a clean, covered container
- Wine, beer, and other alcoholic beverages. These are considered safe.
Avoid contaminated water and animal waste. Don’t swim or wade in water that could have dangerous bacteria. If you go swimming, be sure not to swallow the water. Also avoid animal waste. It can be dangerous for people with a weakened immune system. Wear shoes and use a towel if you rest on the ground to protect your body from any animal waste that may be in the soil. If you touch any animals, wash your hands with soap and water afterward.
Protect yourself against insects. If you’re visiting areas where malaria, dengue fever, or other insect-borne diseases are found, use insect repellent with DEET. If you’re sleeping in these areas, protect yourself with mosquito netting treated with permethrin. When you’re outdoors, wear long pants and sleeves. You may be advised to avoid areas where mosquitoes are known to transmit yellow fever.
Stay away from people with tuberculosis. This is a serious bacterial infection that mainly affects the lungs. It is found in many parts of the world and spread through the air when a person sneezes or coughs. Some people become infected but do not have symptoms. Those with HIV, however, are more likely to get sick. Avoid hospitals and clinics where tuberculosis patients are treated. When you return home, ask your doctor if you should get tested for tuberculosis.
Stick with your routines and protect others. Follow your usual medication schedule and any special dietary guidelines. Take the same precautions you ordinarily would to avoid transmitting HIV to others.
By taking the right precautions, you’ll have the best possible chance of staying healthy while traveling overseas.
