Enjoying the vacation

Travel preparations

Travelling with medication: Do not take a drug holiday when going on vacation. To assure the best treatment possible, it is crucial to take every dose of the prescribed medications. Also be sure to pack an adequate amount. Getting your medication or treatment in foreign countries is not always easy. Long-term travellers in particular should check treatment possibilities for HIV-related problems at their destination.

Entry restrictions: Before booking the trip, check if there might be any problems with customs at your destination. Nowadays more than 150 countries have established entry restrictions for HIV-infected travellers. Some countries screen incoming travellers or may deny entry when travelling with antiretroviral medications. Although these restrictions generally focus on travellers who plan a long term stay - e.g. work-related - they may also affect the humble traveller. Check the Internet or ask at the consulate to be sure. Aidsmap provides a comprehensive list of entry restrictions by country.

Storage of medications: Accurate storage of medications is an important factor. Check if there are special requirements. For example, some drugs need to be kept frozen.

Carrying medications: Make sure that all medications are always at your disposal. Store them in carry-on baggage to avoid such problems as delayed flights or lost luggage. Check in advance if safety restrictions or import regulations include restrictions - especially when travelling by plane. To avoid unnecessary inconvenience keep your medications in their original bottles clearly marked with the prescribing information.

A letter from your doctor: Carry a letter from your doctor with a description of the drugs you are taking and the statement that these are prescribed drugs. This might help you if questioned at customs. It is not necessary to state what your medication is used for so there is no need for a a diagnosis in the letter.

Medical Precautions

Fit enough to take the trip: HIV-related complications often directly correlate to the status of the immune system. In particular, HIV-infected travellers with CD4 cell counts below 200 are exposed to significant risks. Before planning a vacation, honestly ask yourself if you are fit enough to take the trip. Is it safe for you to travel or are complications unavoidable?

Vaccination: Before going on vacation, talk to a doctor. Determine if vaccinations are required at your destination and if it is safe for you to receive them. In particular live vaccines bear an increased risk of severe side-effects for HIV patients. Additionally, vaccinations are less effective for patients with a low CD4 cell count.

Preventing travellers´ diarrhoea: In addition to the usual drugs, a first aid kit for HIV-infected travellers should contain a prescribed antibiotic for treating acute bacterial diarrhoea. Especially in developing countries, there is a high risk of gastrointestinal infections. Adequate drinking water and food hygiene are not always a given. To be sure, obtain additional information from travel medicine specialists.

Food and beverages: In general it is recommended that you avoid the following.

• Fresh fruit and unpeeled vegetables
• Raw or undercooked meat or fish
• Tap water and ice
• Unpasteurized milk or dairy products
• Food prepared in unsanitary conditions (street vendors)
• Remember: "Peel it, cook it or forget it!"

Preventing malaria: Safety precautions against insect-transmitted infections are crucial. Malaria is the best known insect-related disease. It occurs in tropical and subtropical countries. To keep the risk of infection to a minimum there are some recommendations.

Recommendations

• Wear long, bright clothes when outside
• Use insect repellent to cover exposed skin
• Choose insect-free sleeping-quarters - use a mosquito net