Travel
Travel Considerations of persons with HIV
General precautions
- Delay travel until clinically stable and treatment established
- Provide drug prescription / letter listing ART and concomitant medications for comorbidities and referral letter for emergencies
- Provide medical certificate for import of personal medicines/syringes
- Carry ARVs split between suitcase and hand luggage
- Beware of fake drugs
ART
- If possible, maintain hours of medicines (e.g., 23.00 local time) when switching time zones, shortening the interval to the next dose when flying east
- For those on oral ART ensure sufficient supply
- For those on an injectable LA regimen, consider when next injections are due, see Drug-drug Interactions and Other Prescribing Issues
Acknowledge increased susceptibility
Increased susceptibility of persons with HIV(i)
1. Observe food, respiratory and hand hygiene
- Particularly important for travellers visiting friends and relatives (VFR)
- Bacterial enterocolitis e.g. diarrhoeagenic E. coli, Salmonella, Shigella, Campylobacter
- Opportunistic intestinal parasitosis: Cryptosporidium, Cyclospora, Cystoisospora, Microsporidia
- Consider respiratory hygiene including mask wearing if circulating respiratory viruses
2. Prevent insect bites
- Repellents (DEET ≥ 30%), spray clothing with insecticide (permethrin)
- Sleep under insecticide-treated bednet
- Wear long pants and long-sleeved clothes
3. Vaccination and prophylaxis
- Ensure routine, standard of care vaccinations are up to date (see Vaccination)
- Check if travel related vaccines are required (including SARS-CoV-2) and ensure there are no contraindications (eg. Yellow Fever), see Vaccination and wwwnc.cdc.gov/travel/page/travel-vaccines
- Malaria chemoprophylaxis (consider carrying emergency stand-by treatment(ii)
4. Sun safety
- Caution if on drugs associated with photosensitivity (eg. doxycycline, voriconazole, hydrochlorothiazide, amiodorone)
Advice on travel restrictions, see www.hivtravel.org or consular office of destination country
- Higher intestinal susceptibility due to HIV-associated GALT destruction, low CD4 count. More severe malaria with CD4 count < 350 cells/μL
- According to malaria risk at travel destination and national guidelines.
Adherence counselling is particularly important in persons visiting friends and relatives.
See Drug-drug Interactions between Anti-malarial Drugs and ARVs