Letter Sender 3: ARVs and Travelling

Hello guys! 

It's been a while. I haven't checked my mail in what feels like eternity and am quite surprised to see a few messages from blog readers. One of them came from a reader from Malaysia, and here is his message:

"Hi thr. I come across ur blog while researching for upcoming trip. 

Am plhiv from kl. Malaysia. On haart since sept last year. Currently cd4 above 500 n vl undetectable.

I need to travel to swirtzeland on end of nov. Am not worry about immigration or anything. Just i need your advice since am on combivir and efavrinze cocktail.

Combivir for twice a day 8 am 8 pm. And efavirenz at 11 30 pm. When i am bout to go to bed.

My question is when u travel. Do u take med according time of ur origin country i e malaysia. 
If i follow time in msia i need to take the med on 2 am 2pm and 5.30 pm swiss time. 

It will be bit difficult since u know efavirenz can makes one bit drowsy n sleepy. 

One doc suggest if u travel less than 2 weeks just follow malaysia time. Some senior plhiv said if u healthy n stable just follow swiss time. He has been doing it for so many times n ok.

But am afraid about interruption on meds since willl b pn board for almost 16 hrs. 

Any ideas. Since i think i ll be okay with taking tih swiss time but a bit confuse worry i will prolong time for efavirenz once i touch down on zurich.

Any ideas. Thx so much for ur support."

Here was my reply:

"Hi there,

My deepest apologies for my late response. I have not checked this email for a long time, and I'm surprised that I have quite a few enquiries!

My response may not be relevant to you anymore, but I will share my opinion nonetheless. 

One of my doctors told me that if I were to travel to a place of a completely different time zone, I should follow the local time in my destination. This is for adherence. I've been told that the reason they instruct their patients to take their meds at 8am and 8pm is because these times coincide with activities we do in our normal daily routine (e.g., going to office, having dinner, etc.) which makes it easier for us to remember that it is time to take our meds. 

I also take my meds twice daily, at 8am and 8pm, same as you do. Right now, I'm in Europe, and if I were to follow the local time, then I would have to take my meds at 2am and 2pm, which was difficult to adhere to. So what I did was I took it the same time, as per normal in the Philippines, on the plane, and until the day I arrived at my destination. Then I adjusted taking my meds to 8am local time the following day after I woke up.

So when I travel, if the time difference is not too much, say an hour or two, that will not interfere with my routine, then I take it the same time I do at home. But if there is a huge difference, then I use local time in my destination.

Again, these are my opinion based on my personal experience and my doctor's advice. Please seek your doctor's advice because we have our own peculiarities."

Cheers!

HIVPlus4Plus

Travelling for PLHIV.

One of the most common questions among those newly diagnosed is this: Is travelling abroad still possible?

The answer would really depend on your destination, your purpose of travel and the visa requirements for the country you are travelling to.

There are only a number of countries with strict ban against PLHIV. But most of the ban is imposed only to immigrants or to those securing a work visa. If you are travelling on social or short-term visa, testing for HIV is usually not required in many countries.

My work requires me to travel frequently, even to countries with strict ban against PLHIV. I guess I'm lucky that HIV testing is not required for the short term work visas I apply for, but I do still worry sometimes - what if the time comes an HIV test is required?

Keep in mind that as long as immigration authorities do not know about your status, there is no issue, even in countries which ban PLHIV like Singapore. So it is important that they don't find out about your status. So when you travel, look and be healthy. Don't travel if you are not well. Looking sick might catch the attention of immigration officials. Many airports also have sensors to catch those with fever, and being quarantined is the last thing a PLHIV could wish for.

But what about the medicines? Won't they find out? In my experience, they won't. My bag has gone through countless airport scanners, and I was never asked about the meds I carry, which is quite a lot. But I bring a prescription along, just in case they do ask. I also put them in pillboxes and labeled clear bottles, to make them look more like maintenance medications. They don't usually mind maintenance meds.

I remember my first time going to Australia after I was diagnosed, and the immigration form asked if I was bringing in drugs. I declared yes, and the immigration officer asked, "What type?" To which I replied, "Maintenance meds." She let me through without further questioning.

I also had the courage to send an anonymous email to Singapore's Health Ministry if there would be any problem with me, an HIV-positive individual, going to Singapore on Social Visit with my meds. Their reply was that I can bring up to three months' worth of medicine, as long as these medicines are not in the list of controlled substances in Singapore. Thankfully they weren't.

Here are the countries I've visited so far after I've been diagnosed: Myanmar, Malaysia, Indonesia, Thailand, Singapore and Australia. I've brought three months' worth of medicines to these countries, so if you are PLHIV and are planning to visit these countries on social or short-term visit visa, then worry no more. 

However, if you intend to find work, or even immigrate to another country, it may not be as easy. Each country has its own rule for PLHIV. You may consult http://www.hivrestrictions.org for country-specific restrictions.

Once you are in the country, try to stay healthy. You don't want to be in any situation where they may require your blood. Deportation is possible in some countries if they find out about your status, and I've heard of horror stories from those who got deported.

Have a safe trip!