Knowledge, attitudes and health outcomes in HIV-infected travellers to the USA


Mahto, M; Ponnusamy, K; Schuhwerk, M; Richens, J; Lambert, N; Wilkins, E; Churchill, DR; Miller, RF; Behrens, RH; (2006) Knowledge, attitudes and health outcomes in HIV-infected travellers to the USA. HIV medicine, 7 (4). pp. 201-204. ISSN 1464-2662 DOI: https://doi.org/10.1111/j.1468-1293.2006.00371.x

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Abstract

Background The USA bans entry to non-citizens unless they obtain a waiver visa. Aim To establish how many people with HIV infection travelled to the USA, whether they were aware of the travel restriction, whether they travelled with a waiver visa and HIV inclusive medical insurance and how they managed with their antiretroviral medication (ARV). Design Collation of data from cross-sectional studies conducted independently at three different medical centres, Manchester, Brighton and London, using a structured self-completion questionnaire. Results The overall response rate was 66.6% (1113 respondents). 349 (31%) had travelled to the USA since testing HIV positive, of whom only 14.3% travelled with a waiver visa. 64% and 62% of the respondents at Manchester and Brighton were aware of the need of a waiver visa. 68.5% (212) were on ARV medication at the time of travel and, of these, 11.3% stopped their medication. Of those taking ARV medication, only 25% took a doctors' letter, 11.7% posted their medication in advance. Of those discontinuing treatment (n=27), 55.5% sought medical advice before stopping, 11 were on NNRTI-based regimen and one developed NNRTI-based mutation. Only 27% took up HIV inclusive medical insurance. Many patients reported negative practical and emotional experiences resulting from travel restrictions. Conclusion The majority of HIV patients travel to the USA without the waiver visa, with nearly half doing so with insufficient planning and advice. A significant minority (11.3%) stop their medication in an unplanned manner, risking the development of drug resistence.

Item Type: Article
Keywords: HIV-infected, travel to the USA, RESTRICTIONS, Adolescent, Adult, Aged, Anti-Retroviral Agents, therapeutic use, Attitude to Health, Cross-Sectional Studies, England, Female, HIV Infections, drug therapy, psychology, Humans, Insurance, Health, Male, Middle Aged, Prejudice, Reverse Transcriptase Inhibitors, therapeutic use, Stress, Psychological, psychology, Travel, legislation & jurisprudence, United States
Faculty and Department: Faculty of Infectious and Tropical Diseases > Dept of Clinical Research
PubMed ID: 16630031
Web of Science ID: 236460700001
URI: http://researchonline.lshtm.ac.uk/id/eprint/6381

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