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.
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.
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.
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.
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 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.