HIV and holidays

We’re in the middle of holiday season, and I hope that all readers of HIV Weekly who are planning a summer break have an enjoyable time.

The publication last week of a guide detailing entry and residence restrictions that some countries place on HIV-positive travellers served as a timely reminder that taking even a routine mid-summer holiday if you are HIV-positive can entail additional planning.

Before going on holiday it might be worth spending a few moments doing some planning and thinking what you need to do before you go on holiday, and what you could do to make sure everything goes smoothly whilst you are away. A good place to start might want to read the updated chapter on ‘Travel’ in the latest edition of Living with HIV.

Some of the issues you might want to consider include:

• Are you in good enough health to travel? It might sound pretty obvious, but be realistic. Last year I was a little cavalier after being told that I had a multidrug resistant pneumonia. As I was experiencing no symptoms, other than a nagging cough, I told myself I was fit to travel. How wrong I was. Within 48 hours I was rushed to hospital in an ambulance after collapsing with a temperature of 40 degrees. Make sure you have a plan if something does go wrong, including knowing the location of an HIV specialist, or knowing how to get home if you need to.
• Have I got enough medication to travel with? It can be difficult or even impossible to obtain HIV medication or other medicines you need whilst on holiday. At very least, it’s going to be inconvenient and might mean that you lose a day you could have spent on the beach or out sightseeing. Even if you are going away in the UK make sure that you have the right medication – GPs won’t be able to prescribe more HIV medication and it might be difficult to find an HIV specialist who can. If you’re flying, make sure you carry your medicines in your hand luggage – it’s less likely to get lost and you’ll have access to it throughout the flight.
• Will travelling affect taking my HIV medication? Crossing time zones can mean that the time you take your HIV drugs will alter. Also, breaking your routine may mean that many of the prompts you regularly rely on to remind you to take your medication aren’t there. It’s easy to just let go on holiday, but don’t take a break from your HIV treatment without first discussing this with your doctor, or be tempted to skip doses of your HIV treatment because you’re away. You might be risking resistance. Adherence still matters when you are on holiday.
• Have you got the right kind of travel insurance? Routine travel insurance policies specifically exclude pre-existing medical conditions, and some exclude HIV even if it a person didn’t know they had it at the time they made a claim. But there are specialist insurers who will provide cover to people with pre-existing conditions, including HIV, but it can involve a higher premium. The details of some are provided here.
• Going to Europe – got a European health insurance card? Free or reduced cost health care is available to people entitled to NHS care who are travelling in many European countries. You need to have a European Health Insurance Card, which replaced the old E111. To apply for one, click here.
• Planning on going to the USA? Remember, the US bans entry for foreigner with HIV except in exceptional circumstances. People with HIV are detected at US immigration and customs, are held in custody and then deported. To find out about the circumstances when HIV-positive people can enter the US, and how HIV-positive travellers often (illegally) get around the US travel ban, click here.
• Need travel vaccinations? Some vaccinations are not recommended for HIV-positive people, particularly if they have a weak immune system. Talk to your doctor.
• Something for the weekend (or week, fortnight, or month if you’re very lucky), sir/madam? Some people associate holidays with sex. Don’t assume that condoms or lubricant will be readily available where you are going. It’s important to get prompt treatment for sexually transmitted infections, so think about booking an appointment for a sexual health check-up on your return. In some countries (and individual US states) it is a crime for an HIV-positive person to have even protected sex without first disclosing their HIV status.

News

HIV and your body:   Researchers have found that HIV continues to reproduce in the gut, even when a person is taking potent HIV treatment.

HIV and mental health: Study finds that HIV evolves differently in the brain to the blood, perhaps explaining why some very ill people get dementia; and people with a past history of depression are much more likely to stop treatment due to depression after starting efavirenz (Sustiva).

Side-effects: Gene-link to development of peripheral neuropathy during treatment with anti-HIV drugs; and HIV-positive people can have successful heart surgery.

HIV and sex: Many HIV-positive women are infected with multiple strain of human papilloma virus (HPV), often types which involve a high risk of cervical cancer and not covered by the current vaccine; and US researchers argue that laws requiring HIV-positive people to disclose their infection do more harm than good.

HIV and your body

HIV and mental health

HIV-positive people are more likely to experience a range of mental health problems, and there were two news stories reported on aidsmap.com this week on the subject of mental health

Side-effects

HIV and sex

The overwhelming majority of HIV-positive people worldwide were infected with the virus through sex, and the overwhelming majority of HIV-positive people remain sexually active following their diagnosis. Having HIV can affect your attitudes towards, and experiences of sex. Some sexually transmitted infections can have important health implications for people with HIV, and in some countries, the UK included, the criminal law has something to say about the sexual activity of HIV-positive people. There’s a lot more information about all these subjects in the rewritten HIV and sex booklet some HIV-positive people wrote about their experiences of sex for the new edition of Living with HIV; to read their contributions, click here.