Living with HIV is a regular monthly column exploring some of the issues facing gay men living with the virus today. Jim Fielder, living with HIV since 2014, runs services for gay and bisexual men at charity Positively UK. This month he discusses what to keep in mind when travelling abroad.
I plan to travel abroad this summer for a holiday but have heard there are some countries that impose restrictions on people living with HIV. How easy is travelling with HIV these days and what should I consider when planning a trip?
Many people living with HIV travel regularly for holidays, work or to study, and in most cases HIV is not a barrier, but if you want a hassle-free trip it’s essential you do some planning before you leave as this could save you a lot of time and money if things go wrong.
Countries with entry restrictions
Although the number of countries limiting entry to people with HIV is decreasing, some continue to enforce some form of restriction. According to UNAIDS (aidsinfo.unaids.org) as of 2015, there are 35 countries which still have some restrictions, although this is down from 59 in 2008. These are mainly countries in the Middle East, North Africa and Russia. Five countries still have a complete bar on entry. These are Oman, Sudan, United Arab Emirates, Yemen and Brunei Darussalam. Restrictions have been lifted in recent years for the United States and China.
Whereas travelling for short stays (up to 90 days) is OK in most countries, if you are looking to emigrate, work or study in another country, there may be additional entry restrictions including the need to provide proof of your HIV status. The best way to find out what restrictions currently exist is to contact the embassy or consulate of the country you want to visit. If you are an EU citizen, or have the right to live in an EU country, then there should be no restrictions on travelling to another EU member state. Whether this will change post-Brexit is something we’ll need to watch.
If a country you want to travel to does impose some kind of restriction then you will need to decide if you want to take the risk of travelling there or at least how you can better manage that risk. It’s unlikely you will be stopped by customs or immigration, but if you are and they establish you are HIV positive, they may refuse entry and deport you.
Travelling with medication
One of the most important things to think about is how you are going to carry and take your HIV meds. If the country has HIV-related travel restrictions you may get questioned about your meds when going through customs. You can disguise them by putting them in a different container, a vitamin bottle for example.
Or you might take a letter from your doctor stating the treatment is for a chronic health condition and that the medication is for personal use – it doesn’t need to mention HIV. In this case it’s best to use the container the meds came in as it will have your name on it.
Make sure you take enough meds for the trip, and some extra in case of delays, and keep them in your hand luggage or some in different bags to avoid losing them if bags go missing.
Access to medical care and medication supply
If you need to get supplies of your medication after you’ve left home, you may find this very difficult or impossible – which is why it’s important to take enough with you. But in case this happens, make sure you have a record somewhere of the names of the pills you take as they may have different names in the country you’ve travelled to.
If you’re travelling in the EU and you have the right to live and work in an EU country, you can obtain a European Health Insurance Card (nhs.uk/NHSEngland/Healthcareabroad/Pages/Healthcareabroad.aspx). This isn’t essential for you to access HIV meds if you need them, but it will save you a lot of bother and extra paperwork if you do.
Because modern HIV meds are now so good, most travel insurers include cover for HIV-related claims. Insurers will usually ask for your HIV status, but if you’re undetectable and on treatment, you shouldn’t have to pay much of a premium and some insurers do not charge any extra. Remember, even if an accident or illness abroad is not HIV-related, omitting to let your insurer know about your HIV status may invalidate your policy. There are companies that specialise in, or have experience of, insuring people living with HIV. You can find lists at aidsmap.com/Travel-insurance/page/1504589/.
If you need to access HIV meds whilst abroad, an insurance policy that includes HIV-related claims should cover the cost of treatment (check the small print) and if the medication you need isn’t available in the country you are travelling to, the policy should cover the cost of shipping the meds out to you.
It’s always important to check whether you need any vaccines for your destination and if already vaccinated whether these are up to date. Modern HIV treatments don’t interact with vaccines, and even most ‘live’ vaccines these days are fine if you’re living with HIV and on treatment. However, it’s worth discussing this with your doctor or someone in your HIV health team in good time before you travel.
Talking about your HIV when you get there
Finally, it’s worth remembering that people’s attitudes and levels of knowledge about HIV may be very different outside of the UK and to what you are used to. Be aware of this, particularly when deciding whether to talk about your HIV with guys you meet or hook up with. People in countries where homosexuality is less accepted, or illegal, are more likely to view HIV in a negative light, so be discreet.