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Travelling with HIV

by Ron Meijer in Travel and weekendtrips , 24 juli 2005

Dit artikel is ook in het Nederlands beschikbaar

As flying away on holiday becomes cheaper we’re travelling more often and further beyond our borders. And last minute bookings are also attractive. As planes must always be fully booked often the last seats go for a song. The advantages are all ours. Or so it seems, but what we rarely contemplate are the necessary vaccinations we need against sicknesses we’re unfamiliar with here in Holland but are, in distant tropical lands, life threatening. Many a man returns from vacation to find himself at his doctor with a variety of symptoms that could’ve easily been avoided had he taken the time to be vaccinated against sicknesses prevalent in other lands.

Hightened risks

Every year approximately one million Dutch men and women travel to areas with higher risks of infectious diseases and where vaccination is advised, such as countries in tropical Africa, South and Middle America, Asia, countries from the former Soviet Union and around the Mediterranean, such as Morocco, Turkey & Egypt. In general, travellers are healthy people, but a certain proportion are more vulnerable. More elderly people are now travelling, people with health problems, people who are on medications and HIV positive people with compromised immunities.

What once was called “adventure travel” to distant and exotic lands is now just a normal holiday for many. The percentage of this vulnerable traveling population in unknown, but is increasing according to health organisations. The risk for these travellers is greater as many take out inadequate precautions. Vaccinations sometimes don’t work or are less effective as they could be. No matter the uncertainties, in this article we enlighten our readers over the situation for HIV positive men and travel.

What preventative medication can be used in connection with HIV medication (for example) on your holiday? It’s advised to take normal medications in your carry-on luggage. This is especially true in light of lost baggage or delays during travel. Then you’ll always have necessary medicine with you. You should also always have with you relevant medical documents from your doctor about these medications including the reasons for using them and that it is for personal use only (without specifically mentioning they are HIV medication or the specific name of the medication). Such a declaration in English is available from your AIDS specialist. It is also possible to obtain a “medical passport” from your AIDS specialist. This is an outline of the medications that you take. This can be handy when you’re travelling for long periods and need to obtain medications whilst abroad.

Then there’s the question of the importance of precautions to be taken against health risks. In foreign countries standards of hygene may differ and food is often not what you may be used to back home. It’s important to realise this, expecially if you have a lower immunity. Sometimes, if you’re in a warm country and taking specific medicines (such as Indinavir), it’s necessary to drink extra water to prevent kidney stones. You should also consider taking with you treatments against diarrhea. Additionally, it’s always good to inform yourself if you need vaccinations as some vaccinations aren’t advised for HIV positive people.

Use of HIV inhibitors in warm countries

If you are using combination therapies and are travelling to warm countries you must drink more than you would normally. Not only when you take your medication but during the entire day. This applies especially for Indinavir (Crixivan). Drink plenty of mineral water, fruit juice and other liquids (not alcohol). And also in many European countries it’s advisable when drinking, taking medication or brushing teeth to use bottled mineral water to prevent possible infections from unclean tap water.

Take good notice of the instructions on your medication. Ritonavir (Norvir) can last 30 days out of the fridge but only if the temperature is less than 25 degrees Celcius. Specialist sports stores sell small cool boxes and in a plane you can place these medications in cooling. Indinavir must be kept dry so make use of the moisture absorbant sacks found inside Indinavir bottles.

Extra medication

While travelling you may suffer from other medical problems, for example diarrhea. For precaution, take extra medication. Discuss with your doctor what best to take with you. With persistant diarrhea an anti-biotic may be prescribed. If you use Bactrimel (co-trimoxazol) you may suffer from a heightened sensitivity to light. So use a good sunscreen and take talcum powder to keep your skin dry. With anti-malaria products make sure these don’t adversely affect your combination therapies. Some anti-malaria products react badly with some HIV inhibitors.


HIV positive people must not take vaccinations that contain live viruses. For the most part there are alternatives, except for yellow fever vaccinations. It is possible to get exceptions for this vaccination.

Not welcome in every country

Unfortunately, it’s still a fact that in a few countries HIV positive people are officially denied entry, for example the US, Israel and Singapore. In transit to the US you will get a form (for people without a VISA this is a blue form, the so-called I 94 W Visa waver). After it’s filled out this form is handed in to Customs. On it is a question about whether you have any infectious diseases. We’ll discuss this is more detail later. Further information over countries with restrictions on entry is available at:

Travel restrictions

Various countries operate travel restrictions for HIV positive people. If you use HIV inhibitors and are in a country with travel restrictions for HIV positive people there is a risk that your medications will be discovered and you will be deported. Some countries allow short stays others don’t. Each have specific rules.

TIP: Ask your doctor or specialist to write a letter (in English or, if possible, the language where you’ll be travelling) stating the reason for the medication. Get your doctor to mention that the medication is for your own use and that it is permissable in the country in question. Most doctors know how to creatively circumvent the travel restrictions of specific countries. It is also advised to familiarise yourself with the embassy of the country where you intend to travel to.

Uncertainty about America

With a comparitively cheap dollar America is now even more an attractive place to visit. But since September 11 the security controls are even more strict. Before you even board the plane you’re asked everything and the little privacy you thought you had is completely gone. But that’s the price we pay for our safety these days and you‘re always free to refuse to answer any questions that pry too much. However, you’ll be home sooner than you’d planned.

To travel to America you must possess a valid passport (dated up to at least the date of your return travel). For extra security it’s recommended that your passport expiry date is at least three months after your return date. If your pasport is no longer valid you cannot travel. There are facilities at Schiphol for Customs to make you an emergency passport.

Take note! In June 2003 a few Belgians hit the headlines as US authorities refused to process their old passports and they were sent back home. US Immigration now requires passports to be “computer readable”. Dutch passports have been computer readable since 1995.


Residents of most Western European countries don’t require Visas to enter the US. These countries are part of the so-called Visa Waver Program. This program doesn’t apply to Dutch citizens that do not possess a Dutch passport. On the basis of the Visa Waver Program you can stay up to 90 days in the US for business or holidays. A Visa waver cannot be extended while in the US and you are not allowed to work or study. You can visit Canada or Mexico but upon return to the US another 90 days will not be granted. You can’t therefore travel outside the US simply to extend your 90 days stay. There are a number of conditions to the Visa Waver Program. If you’ve been charged with drug-related offences or war crimes you cannot enter the US under the Visa Waver Program. In such instances you will need to obtain a Visa through the American consulate.

The necessary form (green I-94) is handed out at check in or during the flight. You must be careful of a few things when filling out this form. You must fill the form in with capital letters and use a pen. Make sure you have a pen with you on the flight. The form must be filled in in English. For example when asked about gender fill in MALE (instead of ‘man’) or FEMALE (instead of ‘vrouw’). You must also fill in the address where you’ll be staying. For travellers staying in multiple hotels fill in the hotel where you’ll first be staying. This is important and will prevent further questioning by Customs. Some travel guides advise stating “travelling through the USA”. This is unacceptable to Customs. You must fill in a valid address so make sure you have the full address with you. Most airlines display during the flight instructional films over the form and how it should be filled in.

A couple of other things::
1: Airlines must participate in the Visa Waver Program. All European and US airliners do that. But if you’re flying with one of the more exotic airlines it’s advised that you enquire if they participate in the program.
2: A Visa Waver doesn’t give you automatic entry into the US. Customs can always deny entry if they suspect (for example) that you are conducting illegal activity or will be seeking to work or stay permanently.

Customs Declaration

Besides the Visa Waver form you must also fill in the Customs Declaration (only one per family is needed - but gay families are not recognised). Along with other details you must also provide information regarding:
If you have more than ten thousand dollars with you;
the value of the goods that you are importing (excluding personal items);
that you have no animals, plants, fruit, meat or other food products with you.
This last point is also important as it’s forbidden to pass Customs with any food products (so leave those apples or uneaten bread rolls you packed for the long flight on the plane!). Some packaged products such as chewing gum or Dutch drop can luckily be kept with you.

HIV & traveling to America

Following the terrors of Sept 11 and the wars in Afghanistan and Iraq, US Immigration has become stricter. US law now requires personal information to be provided to the US Authorities and be checked before you are allowed entry.

Is it now more problematic to travel to the US with medications given the increase in security? It’s well known that US border control has become much stricter. There are various instances of people being sent home on the first plane after filling out forms stating they have no infectious diseases but are caught by Customs with HIV medication in their luggage. Unfortunately, it is indeed true that you are officially denied entry into the US if you are HIV positive. And this is not a recent development - it’s always been so. And not even Clinton thought to alter this. You’ll be given forms to fill in on the plane where you must state if you have an infectious disease or chronic illness and this must be handed in to Customs.

It’s best to fill in this form as if there’s nothing out of order and with no mention of your HIV status. While technically against the law, this can prevent greater problems. If you fill in that you are HIV positive it is certain that you will not be allowed entry. Apart from the nerves about this small deception it’s best to just keep calm. It is advised that you keep your medication in your hand luggage. If you don’t have the nerve to run the risk but still want to travel to the US then you will have to apply for a Visa.

Visa’s are given to HIV positive people as long as they have insurance to cover any possible medical costs incurred while staying in the US. Visa applications are best lodged at least three months prior to your travel to ensure being processed.
Further information over travel restrictions can be obtained by contacting the Service Point of the HIV Union Monday to Friday 2pm to 10pm on (020) 6892577.

With thanks to the HIV vereniging
Jan Langenberg
Kees Rumke



In the New Issue of Gay News, 323, July 2018

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