Travel patterns and health risks for patients infected with HIV

Summary 

International travelers are at increased risk of acquiring infectious diseases. These risks are even greater for individuals visiting resource-poor tropical regions and for immunocompromised travelers, including those with HIV infection. We reviewed ten years of consultative charts from the International Health Clinic at the Ottawa Hospital General Campus to describe travel risks and preventative measures for international travelers infected with HIV. A total of 100 patients infected with HIV (63 male, 37 female; mean age 42.2 years) were referred to the clinic prior to international travel. More than half (57%) were born in countries endemic for tropical diseases. Overall the median HIV viral load (VL) was <50copies/ml (i.e. undetectable) and the median CD4 count was 440cells/μL (IQR=285–630). The most common destination regions were sub-Saharan Africa (55 patients) and the Caribbean (14 patients). Endemic-born patients took longer trips than Canadian-born travelers (mean 45.2 vs. 22.7 days, p<0.05), were more likely to travel to visit friends and relatives (80.7% vs. 4.7%, p<0.05), and frequented regions with higher risks of malaria and other infectious tropical diseases. Endemic-born travelers infected with HIV stay abroad longer and are more likely to visit malarious regions than their Canadian-born counterparts. More research is needed to ensure the best preventive care of these special needs travelers.

Keywords: Travel, HIV infections, Emigrants and immigrants, Tropical medicine