Patrick Green has just returned from a weeklong vacation on Maui. He loved the surf and the spectacular sunsets. But the most enduring gift from the journey, he says, has been its impact on his identity as a man with HIV. "We are pulled in two directions with this disease," says Green, 37, an AIDS activist who lives in Seattle. "There is an urgency about exploring and not leaving anything undone. At the same time, we struggle with issues of safety and avoiding stress. Maui was truly a vacation of the heart."
Green traveled with Destination Discovery, one of a number of tour groups cropping up to meet the needs of people with HIV. With the summer travel season in high gear, here are a few specific concerns to keep in mind whether you're planning an exotic excursion or a weekend getaway.
Thinking of coming home with one of those George Hamilton, darker-than-dark tans? Think again. "People with HIV should take the same precautions as everyone else," says Patrick Hennessey, a dermatologist in New York City. "Use sunscreen and limit exposure to the sun." Certain AIDS drugs -- most notably the sulfa-based antibiotic Bactrim -- may make you burn more easily, and that burn may strain an already-taxed immune system. "Remember, any shade of red -- even a little pink -- is an indication of a burn, not a tan."
It's always a good idea to discuss travel plans with your physician. However, many fine doctors know little about international health issues, so contact a university-affiliated hospital or travel agent who can refer you to a local health clinic that specializes in tropical diseases and travelers' health.
Crossing international borders with HIV meds can sometimes be tricky. You can take one of two tacks. Bill Kolber, editor of Out and About, a gay-oriented travel monthly, suggests that you minimize hassles with customs officials by putting prescription drugs in unmarked containers. "You're improving your chances of being left alone if the drugs you're carrying don't raise red flags," he says.
Julie Huffaker, author of The Fearless Flyer, offers different advice. "I'm for taking clearly labeled medications as they're dispensed from the pharmacy," she says. "I'd bring a written prescription on doctor's stationery. I've traveled internationally for years, and this method always satisfied the customs agents."
Passengers with special needs can improve their prospects of satisfactory travel by not leaving anything to chance. When you book an airplane ticket, ask for written confirmation of any special meals or services (medical oxygen, respirator hookup, electric wheelchair) that you have requested. For the flight, Huffaker recommends bringing bottled water to counter dehydration and dressing in layers to cope with fluctuations in cabin temperatures.
With international policies on immunizations and news of disease outbreaks changing all the time, it can be difficult for positive travelers to keep up to date. The best resource is the Centers for Disease Control and Prevention's International Travelers' Hotline. To find out about HIV-antibody testing requirements, check anonymously with the embassy or consulate of the country you're planning to visit. The existing regulations are generally for people planning extended stays (usually more than three or four weeks). Few countries currently require an HIV antibody test for a casual traveler.
You're more likely to be pulled aside for an expired passport (check it now!) than to be questioned about your serostatus. However, in rare cases, medications, medical devices such as syringes or Hickman catheters and physical manifestations of illness have all served to attract the attention of customs officials.
Once you've breezed through customs, before you hit the beach or museum, identify competent local medical service. "I'd get a referral to an English-speaking doctor and find out about medical evaluation and prescription replacement," says Kolber. "There are insurance companies that maintain all your medical records and provide multipage fax histories anywhere in the world."
To be sure, travel has many benefits. It can be a way to expand, to rest, to regroup. For PWAs, it can mean moving out of isolation and celebrating life.
Soren Nielsen is itching to hit the road. A 45-year-old HIV positive actor from Denmark, Nielson is traveling to Atlanta this summer for the Olympics. "I'm so excited, I can barely sleep," he says. "It's something I've always wanted to do." Is he nervous about entering the U.S., with its odious ban on people with HIV? "I've been assured there's little risk, so I'm not expecting any problems," Nielson says. "If something happens, I'll deal with it when I get there. My focus is entirely on having a wonderful trip."
I'm sold. Grab your sunscreen, and let's go.