Travelling abroad

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If you love to travel, living with HIV won’t stop you. However, it is important to know that unfortunately, some countries still refuse entry to HIV positive people, even for short stays. Even Canada has some restrictions for visits of six months or more. The wisest course is therefore to make sure you are informed about a country’s travel restrictions before planning a trip, as well as the measures each country uses to bar a person living with HIV from entering. This will make it easier for you to decide whether or not a country is worth visiting. These restrictions are becoming less and less common though, and even China has rescinded them.

The HIV Travel site offers detailed and generally up-to-date information about the restrictions still in place in certain countries for people living with HIV.

The information contained here offers tips to help make travel easier, regardless of the restrictions in place in the country you are visiting, and clarifies the rules for travel to the US, where HIV travel policies were revised in January 2010.

  1. Medication
  2. Insurance
  3. US policy
  4. What about China?

1. Medication

First of all, lying about the cross-border transport of drugs is prohibited, even in the case of prescription drugs. If you are asked to declare your medications at customs, you must do so or you risk criminal prosecution. Medications should always be identified (with your name, the name of your physician, and the pharmacist’s contact information, all of which are usually written on the document provided by the pharmacist), and transported in your carry-on bag, to facilitate inspection. A medical certificate or physician’s letter written in the language of the country you are visiting, or at least written in English, may be required to justify the medication you are taking with you.

Restrictions on the amount of medication you are allowed to bring with you vary from country to country. It might be possible to bring a 90 day supply of drugs into one country, while others may only permit more limited quantities. It is important to inform yourself before planning a trip.

What should you do if you want to travel to a country that restricts access to people living with HIV? You may need the cooperation of your physician and pharmacist. You can ask your doctor to provide you with a medical certificate or letter explaining that you are on medication for chemotherapy or to treat an immunodeficiency. These explanations have the benefit of being both correct, and vague. You could also ask your pharmacist to deliver your medication in a transparent container, identified by its scientific name only so that the drug’s common name is not recognized.

Note that the following strategies are not suggested:

  • Sending your medications ahead to an acquaintance at your destination – this could be complicated, and there is a risk that your medication will not arrive
  • Trying to buy your medication at your destination – the RAMQ will not refund you for drugs purchased abroad
  • Note that you are strongly advised, from a therapeutic standpoint, not to interrupt your treatment without consulting with a physician

For more information visit: Travelling with medication (Canadian government site).

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2. Insurance

RAMQ provides only a limited amount of coverage for out-of-province healthcare. As a result, like many travellers, you may choose to buy travel insurance to cover health expenses while travelling. You should be aware though, that some travel insurance policies limit or exclude coverage related to HIV. It is best to check to see what preexisting conditions are listed in the contract before buying insurance, and to ensure that you understand how the coverage works before you leave in case you have HIV-related health issues during your trip.

Additionally, if you are absent from Quebec for more than 183 days (six months) in a single calendar year, consecutive or not, you must inform the RAMQ. If you are out of the country for work or study, you will continue to be covered whenever you are on Quebec territory, regardless of the duration of your time abroad. Otherwise, you will not be covered at all for that entire calendar year. For example, if you leave Quebec in April for more than 183 days, you would have to reimburse any amounts paid by the RAMQ from January until March, and any services received upon your return. Once every seven years, though, you are entitled to a special dispensation. This would allow you, ONCE every seven years, to leave for more than 183 days in a calendar year without having your coverage be affected.

As these provisions are fairly complex, you may want to contact the RAMQ for more information before planning a long stay abroad.

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3. US policy

As of January 4, 2010, the United States completely eliminated travel and immigration restrictions for people living with HIV. In fact, HIV was removed from the list of Communicable Diseases of Public Significance, since it is not considered a communicable disease. There are now therefore no HIV-related restrictions either for travel or for immigration. Visas and special waivers, which had been necessary for people living with HIV who wished to legally enter the United States since 1987, are no longer required.

These measures have now likely been in place for long enough that American customs officials are aware that the restrictions have been abolished. However, if you experience difficulties because a customs officer knows you are HIV positive, ask to speak with a supervisor.

Visas, waivers, and refused access

Difficulties could arise if, under the old rules, you had requested a visa or special waiver, or you had been refused access to US territory because you are HIV positive. Unfortunately this visa or waiver, which will always be part of your file in the US, covers an array of diseases (like tuberculosis and other communicable diseases) and doesn’t specify which disease you have. As a result, a customs officer could ask you for proof that you do not have any of the diseases still on the list of Communicable Diseases of Public Significance.

We consulted with US customs authorities to officially find out how to proceed in this situation. Unfortunately there is no official procedure, however a director of the US customs agency recommends taking the following precautions:

  • If you have a copy of the exemption request and/or visa, bring one with you
  • If you no longer have these documents, ask the physician who signed the original exemption request or visa to give you written confirmation, in English, that they completed your visa or exemption request form for reason of HIV only, and ask that they include the approximate date of the request
  • If you are no longer in contact with the physician who signed your original form, ask your attending physician to write a letter in English explaining that you have HIV, but no other communicable diseases that could jeopardize public health
  • If you have problems at customs in spite of these documents, you can ask to speak with a supervisor, who can verify that HIV was the only reason you were restrained from entering American territory

Note that the above-mentioned documents only need to be shown if a customs officer asks you questions about your health-related travel restrictions. Most likely, you will be allowed to enter without needing to provide any verification of your health status. However, if you do encounter questions, presenting the above documents should allow you to more easily gain entry to the United States. For more information, you can also visit the American government website, Travel.State.Gov .

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4. What about China?

China lifted restrictions on the entry of visitors living with HIV based on their HIV status on April 28, 2010. This change does not affect immigration. People should therefore no longer be subjected to unexpected blood tests at the Chinese border. However, taking the newness of the change into account, and the fact that laws in China can sometimes be interpreted liberally, it is not recommended to disclose or broadcast your HIV status (by wearing a red ribbon, for example).

Macao and Hong-Kong have separate policies for entering their territories, and do not restrict entry to people living with HIV.

Happy travels!

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VIH INFO DROITS does not provide legal advice or counsel.

The information in this document is not intended to council the public, and does not replace the services of a lawyer. Although we monitor legal developments, we cannot guarantee that the information presented here is up to date.

COCQ-SIDA cannot be held responsible for any damages resulting from the use of the information contained in this document.