HIV infection and travel precautions
Travelling overseas can expose you to many diseases that you are not exposed to at home. Taking precautions for preventing exposure to these diseases is always important, but even more so for people with HIV infection, especially those whose immune systems are severely compromised.
If you have HIV, you should discuss your travel plans and the countries and areas you intend to visit with your doctor, or a travel medicine professional, to plan what precautions are necessary for you.
When planning a trip, there are several precautions that you should take.
Food and waterborne diseases
If travelling to developing countries, you should be careful about food and waterborne diseases, such as Hepatitis A.
Food and drinks — especially raw fruits; raw vegetables; raw and undercooked seafood; meat; tap water; ice made from tap water; unpasteurised milk and dairy products; and food and drinks purchased from street vendors — can carry risk of contamination.
Food that has been well cooked by a reputable source; fruits that you peel yourself; bottled water (especially carbonated); hot beverages such as tea and coffee; or water that has been boiled then cooled are generally considered to be less risky.
If you need to use local sources of water and it’s possible to boil the water, you could consider taking a portable water filtration unit to increase the safety of the water.
Waterborne infections can also happen if you swallow water when swimming or undertaking any other recreational water sports.
To reduce the risk of catching waterborne diseases such as cryptosporidiosis and giardiasis (intestinal illnesses caused by tiny organisms), you should always avoid swallowing water when swimming and, if possible, do not swim in water that you do not know the source of. Unfortunately, many areas that you may want to swim in may be contaminated with sewerage or animal waste.
Travellers’ diarrhoea
Unfortunately, some of the antimicrobial medications available for preventing traveller’s diarrhoea are not recommended for HIV-infected people as they are known to have adverse effects and may promote the emergence of drug-resistant organisms.
However, in certain circumstances (such as travel in an area where the risk of infection is very high), your doctor may consider it necessary to prescribe preventive antibiotics. You should discuss this matter with your doctor or a travel medicine professional.
However, you should take some type of antimicrobial drug when travelling in developing countries in case diarrhoea develops. You should consult your doctor as to the type that would be best suited to you.
If you do experience diarrhoea when travelling, medications such as Imodium and Lomotil may be of benefit. However, if the diarrhoea persists past 48 hours or is accompanied by blood in the stools or fever with shaking chills, or if you become dehydrated, you should discontinue these medications and seek medical attention immediately.
Malaria
You should discuss with your doctor or travel health professional the preventive measures you should take if you intend to travel in an area that may expose you to malaria.
Vaccinations
When considering vaccinations that may be needed for travelling, it is recommended that HIV-infected people avoid live virus vaccines.
However, one exception to this is the measles vaccine, which is recommended for people who do not already have immunity. This vaccination, however, is not recommended for people with severely compromised immune systems and another form of vaccination should be used.
If you need a polio vaccine an inactivated (or killed) polio vaccine should be used instead of the oral (live) polio vaccine.
If you will be at risk of being exposed to yellow fever, you'll need to discuss the use of the yellow fever vaccine with your doctor or travel health professional, as this is a ‘live’ virus vaccine. If vaccinated, you could have an adverse reaction to the vaccine. In addition, the efficacy of the vaccine can't be guaranteed in people with HIV infection.
If you are travelling in areas where yellow fever is a risk, you may need to look at preventive measures and if you do not have the vaccination you may need a waiver letter from your doctor.
Because HIV-infected travellers can receive inactivated (killed) vaccines, in general, you can receive protection from diseases such as tetanus, rabies, and Japanese encephalitis. However, the current cholera vaccination is not recommended for HIV-infected people.
Other risks
Finally, you should ask your doctor or travel health professional about other specific areas of risk in the countries in which you’ll be travelling and discuss ways to minimise your exposure to infections.
HIV-infected travellers are at greater risk of infection from diseases such as visceral leishmaniasis, which is transmitted by sandflies; and a number of fungal infections. Also, many tropical and developing countries are considered high risk for tuberculosis.
Last Reviewed: 14 October 2004
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