Avoiding other illnesses abroad

While vaccination can help prevent some travel illnesses, there are other illnesses related to travel which need to be considered. 

Studies^1,2 have suggested that many HIV-positive travellers take risks with their health when travelling. This includes taking more risks with sexual health than would be taken at home.

For those offering advice to people with HIV, drawing attention to the increased chances of sexual risk taking can help people to make more informed decisions. It may be helpful to refer people to a helpline such as THT Direct (0845 1221 200), the African AIDS Helpline (0800 0967 500) or the Sexual Health Line (0800 567 123).

Travellers’ diarrhoea can cause extra problems for people with HIV as it can lead to HIV medications not being absorbed into the body properly, which can make them less effective.

Over-the-counter remedies can be bought from the pharmacist without prescription before travelling. However, these should not be used if the diarrhoea is accompanied by other symptoms, such as fever, bloody diarrhoea or feeling generally unwell. In these circumstances, a healthcare professional should be contacted.

Some doctors may prescribe antibiotics which can be taken whilst travelling to try to prevent diarrhoea. Doctors can use an antibiotic which is likely to be effective in killing the most common microbes associated with travellers’ diarrhoea to give protection against symptoms.

GPs will be reluctant to prescribe these antibiotics unless HIV is discussed. If someone with HIV informs their GP that diarrhoea could mean that HIV medication is not properly absorbed, these antibiotics may be considered. Some people with HIV may not want to disclose their HIV status to their GP so the option of antibiotics for travellers’ diarrhoea can be discussed with an HIV doctor. An antibiotic against travellers’ diarrhoea called Clarithromycin may interact with HIV drugs, so it is advisable for all HIV-positive travellers to discuss travel medication with their HIV doctor, and to check the information provided with medicines for any known interactions.

A deep-vein thrombosis (DVT) is a blood clot that usually develops in the veins of the leg, usually the calf. It can occur days or even weeks after a long trip. Symptoms include intense pain in the affected calf and medical attention should be sought immediately, since if the clot makes its way to the lungs it can be fatal. People who experience DVT usually have three or more of the following risk factors:

• immobility for an extended period of time

• dehydration

• chronic illness, including HIV

• cancer

• recent surgery

• existing clotting abnormality

• obesity

• taking hormones or the oral contraceptive pill

• varicose veins

• pregnant or had a baby within two months

• a history of heart problems.

As noted above, people with HIV may be at a higher risk of DVT. Moreover, all travellers are at risk of a DVT, albeit quite small, due to immobility for long periods. This may be from a long flight, bus journey or other long journey. Avoiding some of the risk factors above may help to decrease the likelihood of a DVT. The risk can also be decreased by making sure legs aren’t immobile by moving them around or taking breaks to walk, as well as remaining well hydrated, although this is not proven. Flight socks or travel stockings may also provide some protection.