Travel Tips for People Living with HIV

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Many of the newer HIV drugs have fairly easy dosing schedules. Compared to the "old days" when people living with HIV took handfuls of pills three and four times a day, some people now can take one or two pills just once or twice a day.

Whether you are taking one pill or several, from home or from an exciting travel destination, it is still important to stick to your assigned dosing schedule. Traveling with your HIV drugs – and staying on your schedule – can seem hard or scary at first, but HIV should not prevent anyone who needs to travel for work or wants to see old friends or new places from doing so. And once you get the hang of it, it can be quite easy to manage your medications while you are on the road.

Pack Your Pills First

It is one thing if you forget your socks, or your toothbrush, or even your cell phone. You can replace these items when you reach your destination, or you can get along without them. You cannot get along without your HIV drugs, not even for a day, so pack them first – and pack them carefully.

Count out your pills for how long you will be away and transfer them to appropriate containers. It is wise to take a two-day backup supply of your HIV drugs with you in case of any travel delays. At home you may use a subdivided multi-day plastic pillbox to hold all your drugs, but for travel it is often more convenient to carry your pills in something smaller, such as sturdy plastic bags that can be resealed, or a pocket-sized plastic tackle box. However, if you are traveling internationally or anywhere by plane, you should carry your medications in their original bottles clearly marked with the prescribing information so that security or customs will not give you too much trouble.

Pack your pills in a carry-on bag – and nowhere else. There is no guarantee that your flight will depart on time or arrive on time or that checked baggage will be waiting for you at your destination.

If you carry your pills on board, you can take any doses you need while on the plane and you will be prepared to take additional doses later if there is any travel delay. The airline may not be able to keep to its flight schedule, but you will be able to keep to your dosing schedule – and that is the important thing.

Food and Water

The HIV drug regimen you are on may have food restrictions: certain pills should be taken on an empty stomach, others must be taken with a meal or snack, and all of them should be taken on schedule.

Not all airlines offer food on flights these days, and even if they do, there is no way of knowing when you will get fed on an airplane, or whether the food will be anything you want to eat. It is best to carry food with you if you need to eat when you take your medicine.

The same is true for water. If you are driving or taking a bus or train, you should bring your own. However, with some of the latest airport restrictions you may have to ask for water rather than take it on board with you. It may be possible to bring an empty water bottle through security and either fill it before you board or have a flight attendant fill it once you are on the plane.

Most of the time, the flight attendants will help you out by bringing water right away if you mention that you need to take medicine. Asking for water as soon as you board the plane is a good plan. If you have ever flown across the country, you may have noticed how long it can take a group of flight attendants to get down the aisles of an airplane with a beverage for each passenger. You may find yourself with a very dry mouth and unable to swallow even a single pill, so it is important to ask for water in advance!

If you are flying, it is good to drink plenty of fluids anyway; the recycled air on airplanes is very dry and several hours of flying can be dehydrating. To varying degrees, dehydration (having too little water in your body) affects all passengers on long flights, and people living with HIV need to be especially careful that they do not allow themselves to get dehydrated. So, take every opportunity to get a beverage and make a point of drinking throughout the flight, not simply when you feel thirsty.

Adjust Your Dosing Schedule

Adjust your dosing schedule according to the number of time zones you cross. This sounds tricky, but it is actually quite simple.

West to East

As you travel from west to east, take the next dose of your HIV drugs one hour earlier than you usually do. If you cross more than one time zone, take the following dose again an hour earlier to make up for the second time zone, etc. For example, if you fly from Los Angeles to New York, you cross three time zones. Let's say you normally take your medications at 10 am each day, and you leave Los Angeles at 6 am local time. You would take your next dose at 9 am Los Angeles time (which is noon New York time) that day, the following dose at 8 am Los Angeles time (which is 11 am New York time) on the next day, and the third dose at 7 am Los Angeles time (which is 10 am New York time) on the third day. Now you are back on your normal 10 am schedule.

East to West

When you travel from east to west, you reverse this process – adding an hour between dosing cycles. If you fly from London to Boston, for example, you cross five time zones and after five slightly longer dosing cycles you will be back on your normal schedule.

Taking your doses an hour earlier, or an hour later than usual falls well within the approved range for adherence to any dosing regimen.

North to South or South to North

When you travel north to south (or vice versa), there is no need to make any adjustments. Just stick to your regular dosing schedule, even on an 11-hour flight from the US to Argentina. You only need to adjust your schedule if you travel across time zones (i.e., if you have to change your watch).

Traveling Outside the US

Do a little research about your destination. If you are going to another country, check if there are restrictions about visitors living with HIV or traveling with medications. You may also want to take a set of written prescriptions.

If you travel to developing countries, you may be at a greater risk of getting cryptosporidiosis (an infection caused by a parasite; also an opportunistic infection) from contaminated food and water. The following are more likely to be contaminated:

  • raw fruits and vegetables
  • tap water or ice made from tap water (it is best to drink filtered or boiled water, even when brushing your teeth)
  • unpasteurized milk or dairy products
  • items purchased from street vendors

Talk to your health care provider about other precautions you may want to take when you travel abroad (i.e. getting vaccines, bringing antibiotics). Often, getting vaccinated for hepatitis A is a good idea, if you have not been vaccinated already. 

Depending on where you are traveling to, you may need to see a doctor before you travel in order to get medicines you may need to prevent infections, such as malaria, and receive required vaccines that are not available at your regular health care provider. You will need to take these treatments more than a month ahead of time in order for them to work during your travel. The US Centers for Disease Control and Prevention (CDC) has a list of recommended immunizations for adults living with HIV.

Reminders

It can be relatively easy to stick to your daily schedule of pill-taking when you are at home. You are in your usual place, your pills are in their usual place, and your routine is familiar. It can be harder to stick to your daily schedule of HIV drugs when you travel, especially when you travel to an unfamiliar destination.

To make sure you do not miss any of your doses or leave your HIV drugs behind, it helps to travel with brightly colored Post-It or sticky notes. Put them on the bathroom mirror, on the dresser top, on your suitcase, on your car keys, on your hotel or motel room key. Those flashes of bright color will remind you to take every dose of every one of your medications every day and they will remind you to take your pills with you when you leave.

If bright colors or sticky notes do not work for you, plan ahead and find out what does work. Perhaps your cell phone can be set to alert you when you should take your pills. There are now many apps available that can track medications you've taken and generate reminders to take ones in the future. This link has several examples listed under the 'Medication Management and Compliance' section. Or perhaps you can get a friend to help you remember, whether she is traveling with you, calling you from back home, or sending you reminders via text or email. The important thing is not what form the reminders take – only that they are effective, and you take your HIV drugs on time.

Taking Care of Yourself

While planning ahead for how you will stick to your regimen may seem like a hassle, it will make it easier when you are on the road. Good planning before you travel can help you relax and enjoy your trip. Even if you are on vacation, your HIV drugs still need to keep working! So, do not leave home without them!

Additional Resources

Select the links below for additional material related to travel and HIV.
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