Last fall in San Francisco, nearly 850 health care professionals from more than 45 countries met to discuss one of the fastest growing trends in health care: medical tourism—the phenomenon of people traveling to other countries for care and treatment that’s cheaper than those offered at home. It makes sense. With the cost of surgeries and insurance deductibles rising worldwide, not to mention that certain procedures aren’t available in some countries, hundreds of thousands of people travel abroad each year in search of a wide variety of less expensive services—ranging from cosmetic procedures to heart surgery. Even in the wake of the current U.S. recession, an estimated 6 million Americans will seek medical care beyond our shores by 2010.

It says a lot about the state of health care in America that it’s cheaper to skip town. But given the harrowing costs of AIDS meds, we wondered whether HIV-positive Americans were traveling internationally to buy their antiretrovirals (ARVs) at a discount. The short answer? No. This may be because more than 500,000 Americans get financial help accessing their meds through federal programs such as the Ryan White CARE Act and AIDS Drug Assistance Programs (ADAP). In addition, pharmaceutical companies’ patient drug assistance programs help those who struggle to pay for them on their own.

But there is an HIV connection to medical tourism. An increasing number of HIV-positive Americans travel internationally to receive cosmetic surgery for facial lipodystrophy—and not just to pinch pennies. Some of the best solutions to rebuilding a healthy-looking face are not (yet) approved by the United States’ Food and Drug Administration (FDA). Admittedly, this isn’t happening in droves, but those who can afford it claim that traveling to mask the telltale signs of facial wasting—hollow temples and sunken cheeks—is well-worth the price tag of the trip, the stay and the procedure.

While lipodystrophy—a metabolic syndrome caused when certain ARV combos redistribute body fat and/or deplete fat in the face and limbs—is not life-threatening, it can be extremely stigmatizing. For some, it can take away the power of voluntary disclosure, which in turn can cause poor adherence and even lead a person to stop ARV therapy altogether.