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

  1. Higher intestinal susceptibility due to HIV-associated GALT destruction, low CD4 count. More severe malaria with CD4 count < 350 cells/μL
  2. 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