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Opinion

Disclosing Your HIV Status Abroad: A Dilemma for People Living With HIV

May 22, 2014

Disclosing Your HIV Status Abroad: A Dilemma for People Living With HIV

When the doctor asked me if there was anything she should know about my medical history, I was reluctant for a moment, but then quickly blurted out, "I'm HIV positive." Having been recently diagnosed, but healthy and on medications, I felt it appropriate to alert her. Knowing now that muttering that sentence almost killed me, I wish I would have taken an extra moment to consider if disclosing my status in that situation was the right thing to do.

Disclosing Your HIV Status Abroad: A Dilemma for People Living With HIV

It had been a long week of feeling really ill. I remember staying in and missing Christmas and New Year's with my family because I was just too sick to do much. I had to eventually get on the bus and take a long, winding road for eight hours from Cochabamba to La Paz, as my job at the time was waiting for me to return after the holiday break. I was teaching English back then, overseas in Bolivia where some of my family is from and had taken a trip to another city to spend time with relatives. After a few more days of just not getting better, I decided I had to make the trip, and visit a doctor upon arrival. For the week leading up to this, my family and I just assumed I had a stomach virus or the flu. What we didn't know was that I actually had something extremely rare nowadays, but something still possible in South America. I had traveled to Bolivia so many times in the past and never had any issues, so I never opted to vaccinate myself for anything really. I just preferred to take my chances. I thought I was invincible.

"The moment I disclosed is the immediate moment I witnessed how awful it felt to be discriminated against by a medical professional."

A couple of days after my arrival in La Paz, I was able to go to a doctor that a friend recommended. I didn't have insurance in Bolivia, but I was covered partially through a pay-in system I had at the time. The moment I disclosed is the immediate moment I witnessed how awful it felt to be discriminated against by a medical professional. Don't get me wrong, the doctor did her job and examined me, but she was reluctant about it. Her diagnosis? Typhoid fever that required immediate hospitalization. As I lay on her examination table with my cousin by my side, I heard her call up the nearby hospital. The first thing she uttered was my status and then continued on. I could tell by the tone of her voice that something was not right. Strangely enough, that hospital was full or just couldn't accommodate me. The doctor called another, and again, HIV was the introduction. As the list of nearby hospitals continued to diminish, I realized at that moment, that no hospital wanted to help me. We began to panic and my cousin put me in the car and just drove me to a few emergency rooms. The resounding responses were the same as they were on the phone. It's almost as if a phone tree had been put in place and I was now a red flag. Some hospital administrators gave us hope and made us wait, only to disappoint us in the end.

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What happened next was something I would never imagine, almost as if it was out of a movie. The doctor who had diagnosed me basically asked for cash to treat me, but not in her office. We had no choice but to go to a pharmacy with a list of supplies needed and set up a makeshift hospital room in my cousin's house. The doctor would come and examine me twice a day, but not without making me feel like a disgusting human being while doing so. She insisted on wearing at least two pairs of gloves while touching me and instructed my cousin to burn all the sheets and supplies after I had used them. We were also to alert the government that an HIV patient was at this particular residence and to make sure nobody else came in contact with me. My family in Bolivia had just recently found out about my status and although they didn't know much about HIV, they were still more educated on the matter than this doctor was. After a few nights of being watched 24 hours a day by my family, the doctor insisted I was well enough to leave the country immediately. This horrific experience was in 2009 and I haven't returned since.

Disclosing Your HIV Status Abroad: A Dilemma for People Living With HIV

Had I never disclosed my status, I would have quickly been treated, rather simply actually, as all I needed was constant hydration and medication. I would have spent a few days in the hospital and left rested and recovered. I would have then returned to my job, continued the life I had there at that time, and completed my experience before returning home and later planning more return trips to spend time with my family.

Not every country is as open-minded or educated as the U.S. when it comes to HIV, and it's a scary thought to have to even consider disclosure when in a medical emergency overseas. What would have happened if I were in the Middle East or Asia? Some countries in these regions flat out ask HIV status prior to granting a visa. Is disclosing status something I would need to do if I was being treated for something unrelated to my HIV? My first instinct in Bolivia was correct. I was recently diagnosed, was on medication and felt that the doctor should know. I wish I wouldn't have said anything, but in the end, it taught me a valuable lesson.

"As an HIV-positive person, I would never let my status deter me from going anywhere; I'm just more prepared and informed of the places I am visiting prior to booking my trip."

As someone who travels constantly and consistently, I am now cautious as to where I am going at times and always spend a few extra moments to research my "what ifs." What if I get sick? What if I need more meds? What if I need emergency care? Sometimes what I find isn't the ideal answer, but I plan accordingly. Traveling is one of the best things anyone can do in his or her life. As an HIV-positive person, I would never let my status deter me from going anywhere; I'm just more prepared and informed of the places I am visiting prior to booking my trip. My personal experience in Bolivia didn't scare me about traveling overseas. It just taught me to be more vigilant about my planning and what I should say or not say in certain situations or places. HIV is manageable. If you are healthy and taking care of your body, as well as on medication as instructed by your doctor, being sick because of your status is most likely a nonissue. Your only worries about traveling and being sick should be the same as anyone else who doesn't share your positive status. What if I get a cold, or a stomach virus? What happens if I break my arm? Does my travel insurance cover this or that? Prepare yourself, get your vaccinations, book your trips and know what to do in an emergency. The world is waiting and just because you have three letters attached to your person, doesn't mean those three letters need to keep you from adding stamps to your passport.

David Duran is a freelance journalist and writer based in Brooklyn, New York. You can follow him on Twitter at @theemuki.


Copyright © 2014 Remedy Health Media, LLC. All rights reserved.



This article was provided by TheBody.com.
 
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Reader Comments:

Comment by: Josh (belgium) Mon., Jul. 7, 2014 at 2:44 am EDT
I myself used to work for a multinational severel years ago where i had to travel constantly to countries like India / China & the USA, I am so glad on reflection that i never disclosed my status to any of these badly informed countries. In the USA i know from friends that when you disclose your status they treat you as second citizen, You would think with a wealthy country these issues had past but it seems they still have there heads in sand.
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Comment by: Francis (Switzerland, Europe) Fri., May. 30, 2014 at 6:08 am EDT
Dear David,
I feel indeed that traveling when HIV has some additional challenges and even in the Western world doctors have really discriminating and judging behaviors. Ever since I am on medication, and well informed about the risks and incompatibilities that could exist with medication to treat other illnesses, I know that my immune system is top notch. Disclosing is not a necessity, not for risks of transmission in a medical environment, not for myself. I simply refuse to face the stigmatization by ignorant individuals and therefore I prefer not to disclose in those circumstances.
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Comment by: Greg Freeman (St Kilda Australia ) Fri., May. 30, 2014 at 6:05 am EDT
What an amazing insight. I never realised this sort of medical treatment actually is practiced. In Australia much like America - Our health care providers are very educated. It for me, Raises a point about disclosure, I am fairly open about being HIV positive, however Had never gave any though about your expirence. Great artical.
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Comment by: Jet E. (Chicago) Thu., May. 29, 2014 at 4:20 pm EDT
Thank you for sharing this experience. I fully appreciated it because I recently avoided going to China on a much desired trip because of my HIV status and fear of something similar happening. I was fortunate in that I avoided it, because I would have been devistated. You are brave on at least 2 counts: experiencing this and then sharing it. God Bless you.
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Comment by: Herb Ackley (Seattle) Wed., May. 28, 2014 at 5:49 pm EDT
An interesting post but my main interest was not touched upon, namely how do you manage to get travel insurance when HIVpoz. I can't, and even if I could it wouldn't be worth the paper it was written on as the insurance company would certainly find a way to link an illness (as opposed to an accident/injury of course) to my HIVpoz status. Any advice/recommendations? Thanks.
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Comment by: Rob (London) Fri., May. 30, 2014 at 4:37 pm EDT
Herb - In the UK I got Travel Insurance without a problem and the cost did not go up because my Viral Load and CD4 numbers were good. Have you asked at your local support group for advice? There must be a broker willing to take your business and cover you.


Comment by: Mike (San Fransico, CA) Tue., May. 27, 2014 at 2:16 pm EDT
I'm sorry but that was your fault. Typhoid and hepatitis vaccines are the most basic travel vaccine ever. You never go to a 3rd world country for an extended period without those two. Every backpacker knows that.
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Comment by: Steve (California) Wed., May. 28, 2014 at 9:58 pm EDT
Mike

Thanks for the observation but I think u missed the pint of the story.


Comment by: kg (south africa) Tue., May. 27, 2014 at 6:13 am EDT
i have recently disclosed my HIV status to my friends, and i feel so relieved and confident now, because the secret made me feel uncomfortable around them.
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Comment by: Karleen (Lewes, UK) Fri., May. 23, 2014 at 5:17 pm EDT
I cant believe that in this day and age, we still have ignorance in this world. HIV was first detected in the 80s....We as human beings, have evolved in many ways since then. Medicine has helped HIV Positive people live their life better.

As for countries not allowing anyone who is HIV+ to enter their country or offer any medical assistance - SOD them.....If they haven't learnt by now, I doubt things will change in the near future.

Plus...They are not worthy of you visiting their country David if they see you as a status and not as a wonderful man that you are!! x ;)
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Comment by: Jim (Boston) Thu., May. 29, 2014 at 3:57 pm EDT
Please try to remember that it is only very recently that the US allowed people with HIV to enter this country.


Comment by: Tony (West Hollywood) Thu., May. 22, 2014 at 6:28 pm EDT
Great article, very informative as an HIV positive man that happens to travel as well perhaps a follow up article on online resources you may use to get info? Thanks in advance
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Comment by: Teresa Villalobos Thu., May. 22, 2014 at 6:14 pm EDT
David,
Once again, a beautifully written article.
Mamma T
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Comment by: Alexa Lavelle (New York, NY) Thu., May. 22, 2014 at 6:06 pm EDT
This is a horrific example of the discrimination that occurs everyday. And unfortunately our country is not exempt. When trying to obtain legal status in the US you are tested for HIV and are made aware that a positive outcome could potentially affect whether your application is granted or denied. It is another abhorrent example of this type of discrimination right in our own backyard.
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Comment by: Francis (Switzerland) Fri., May. 30, 2014 at 6:27 am EDT
I must admit that indeed the USA has not been an example for many years. Working for a UN organization where there is a total acceptance and tolerance policy, it was psychologically hard for me to travel for work to the USA since I got infected in 2007. As for the legal status issue you raise, I think it is normal that a country wants to ensure that individuals will not become a financial burden on the fragile health care system. I would suspect that when you have money and/or good care, immigration problems disappear like snow in the sun, as long as you do not represent a public health challenge for the citizens (thus meaning: stay in health care and be treated to avoid spreading the virus).


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