Travelling with HIV: How everyone's experience is different
Travelling at any age can be some of the best moments in a person's life. Frivolous gap years, solo backpacking adventures, galivanting with lifelong friends and making new ones along the way. However, it isn't without its inherent risks and HIV is no exception. In this issue of Poslink+ Quarterly, Brenton discusses some top tips when travelling with HIV, Anth talks to two guys about their journey as positive heterosexual men and Caleb explains what Mpox is and how people living with HIV can protect themselves. This issue also features the evocative and striking work of Melbourne based artist, David Thai.
Don’t let HIV get in the way of experiencing great adventure
by Brenton Geyer
Our Communications Lead and resident globetrotter, Brenton Geyer, shares his experiences and top tips travelling with HIV
I’ve always viewed travel as an opportunity to act up a bit, far away from the routine of life at home. Travel offers the opportunity to live a new-you. To leave your civilian life for a moment and become somebody who you don’t recognise, all the time adding layers of newness, so that you can return home a changed person (even if only momentarily). Often during these experiences, one thing leads to another, without too much of a thought for the consequences… such have been many of my liberating and permissive days (and nights) of global adventure.
HIV and travel are forever intertwined for me. I went through the seroconversion experience while overseas, having had too much of a good time, too often, while travelling many years ago. Even back then, the notion of HIV was never far away from my daily thoughts. As someone who both worked and played in the queer community, I was surrounded with poz folks, some who were (and still are) my friends, others who were colleagues, others who were community identities, and many of whom are no longer with us. My position on the AIDS Candlelight Vigil committee in the early 1990s gave me insight and connection to grassroots AIDS advocacy and my role with ACT UP exposed me to AIDS activism. None of this however, shielded me from exposure to HIV at a time when awareness around the virus was at fever pitch.
One hot and humid night in Hong Kong in the naughty nineties, amongst the Blade Runner like streetscapes of the nightclub district of Lang Kwai Fong, I met a boy who captured my imagination, and we ended up back at my hotel room in Sheung Wan. My memories of this night are crystal clear in my mind. I can even still hear the music. It was one of the best nights of my life, and remains so, despite the outcome.
The next day, I woke with a shocker of a hangover. Nothing new there, but this hangover lingered, and lingered, and lingered. I did all the usual stuff to shake this hangover, but nothing could quite quell the sense of unease I felt. Upon my return to Melbourne, I went to my doctor. Now, HIV is ever-present in my life.
My top travel tips
There are a number of things I prioritise during the planning stages of an upcoming trip to safeguard my health and protect myself from potential peril. Of course, there are lots of things that you could or should do, but here’s what I do.
Travel insurance is a must
These days, if you are on effective medication the insurer won’t penalise you for your HIV status. I know that some people choose not to declare their status to their insurer, but my view is that if something does go wrong and you need to make a medical claim, it’s likely the insurer will discover your omission, giving them a reason to null and void your claim. I’ve never had to make an insurance claim, but I never fail to take out a basic policy just in case I come off a motorbike in Bali or something.
Making sure you sort enough medication is essential
I always take plenty – enough for a week or two supply to last beyond the holiday period just in case for some reason your return home is delayed. I was on a trip in September of 2001 when New York’s Twin Towers were attacked. All the worlds’ airlines stopped flying for about a week after that incident, causing me to have to extend my stay until Qantas was back in the air. Or a volcano could go off, grounding flights for a while, or an extreme weather event could interrupt your itinerary. An oversupply of meds would be a handy precaution if anything like that was to happen upon your travels. I always take my pills in my carry-on baggage, just in case something goes wrong with your checked luggage, and you never see it again. In some cases, I’ve researched the local HIV support groups for peace of mind in case my medications go astray while travelling.
Countries have different regulations that govern the movement of controlled substances, including prescription medications, such as HIV treatment. Almost all have exceptions for travelling with medications for personal use and of the many airports I’ve been through, not once has my pill supply ever been questioned. I’ve never bothered to disguise my HIV meds as vitamins as some people have recommended. In fact, many countries require that medication remain in its original packaging. For peace of mind, you might choose to pack a copy of your prescription or a letter from your doctor confirming that the medication is for your use, which is a requirement in some countries. This need not state that the medication is for HIV. How you approach this may of course differ according to your destination.
Be aware of any travel restrictions imposed upon HIV positive folks
Some countries will differ to others and Positive Destinations is a good guide to friendly and not so friendly places for people living with HIV so that you can plan accordingly. The recently relaunched website contains detailed information about HIV travel restrictions in individual countries and allows you to browse based on the severity or type of restriction, such as those on entry, short term stay, long term stay, and places with unclear restrictions or no restrictions at all.
I travelled to Malaysia last year – a country that is listed as having severe restrictions in place for HIV positive folks. Not once did the issue of HIV come up upon entry or while traveling through the country but of course my experience might not be the experience of others.
Hopefully none of this has scared you off planning a life-changing trip, whether it be your very first, or the next of many since passed. My advice to you is to not let your HIV stand in the way of living your best life and experiencing great adventure in a world of delicious enticement. In the words of Auntie Mame Dennis, “life is a banquet”.
For detailed information about travelling with HIV, visit www.positivedestinations.info
Journeying with HIV; it can bring you closer to yourself
by Anth McCarthy
Anth is a heterosexual man living with HIV who works at Living Positive Victoria as a Peer Navigator. He recently sat down for a chat with Jack and Danny, two other heterosexual guys living with HIV. Read this transcript about their experiences travelling and navigating life with a positive diagnosis.
Please note: some names and details have been edited for privacy and flow.
This article also includes explicit language and mention of drug use.
(Anth) Jack, Danny, can you tell us a bit about yourselves?
(Jack) Sure Anth, I'm 35 years old, I'm a plumber and I come from the UK. I love travelling and I've been here for about eight years. I just became an Australian citizen.
(Danny) I'm also a tradie, I’m a boilermaker and welder. I'm 45 and I grew up in a little country town in Victoria. Like Jack I'm quite keen on travel, and I’ve spent a lot of time working in different parts of Australia and overseas.
(Anth) And when did your journeys with HIV begin?
(Jack) My story begins when I was about 18, when I started experimenting with drugs. I got heavily involved in cocaine in the UK, and once a year, me and 15 or so mates would travel overseas to party. Looking back, I can see how each year our behaviour got riskier. More drugs and alcohol, sex with sex workers without using condoms, crazy stuff like that.
I knew about STIs, and HIV was at the back of my mind, but none of us thought of getting tested or anything. I used to worry that I had picked up something, but I didn't get sick, so I pushed those fears away. I just couldn't face up.
I went to a Catholic school and sex education was minimal. At home we didn't talk about stuff like HIV. All I knew was that you died from it.
One day I was driving along and I suddenly vomited out the car window. And then I became ill. Very ill. I told myself it must be food poisoning but deep down I was scared that I had caught something. I could've asked for help or advice, but what happened was my drug use increased.
Coming to Australia was an attempt to make my life better, but I substituted alcohol for cocaine and began drinking heavily. I was meeting girls in bars and on dating apps, and having drunken, unprotected sex with them.
One day a girl messaged me and said we need to talk. I thought, oh no, this doesn't sound good. She told me she had HIV - and I had this sickening feeling that I gave it to her.
So, I finally went and got tested for HIV. A few days later, I was driving on the freeway when the clinic rang. They knew I was driving, and when they offered to tell me over the phone, I thought it must be good news. But no. They said you've got HIV and you need to come in. I thought bloody hell I'm in a mess.
It was frightening, but I also felt a wave of relief, to finally know and start dealing with it. It had been playing on my mind so much. It was the start of a long process of healing for me, including eventually forgiving myself.
(Danny) HIV was not on my radar at all. I was sticking my dick in anything and everything. Even sober. I didn't care. HIV never crossed my mind.
My parents didn't know how to talk about sex either. Growing up in the bush and marrying young, I wasn't used to wearing condoms. I'd seen the grim reaper, so I knew HIV was out there. I knew Magic Johnson had it, but he was still alive so I thought - it can't be the end of the world.
I was working a lot of FIFO jobs after getting divorced, and I started to do hard drugs. I would jump on a plane and head overseas. We would have a lot of sex on those trips. I have to laugh about some of situations I put myself in, doing drugs, getting wasted in countries where people get locked up.
After one wild trip I got tested for STIs and was all clear - I dodged so many bullets. And, the ironic thing after all that sex while travelling is I caught the clap from a girl in Ballarat!
I thought I was bulletproof. I took so many risks, and got very sick from the drug use. I remember the concern on the face of the doctor who diagnosed me with HIV. I had tested negative a few weeks before, but I was under 50 kgs and injecting meth daily.
My phone call was different to Jack’s, but I knew what it meant. This doctor left me a message saying Danny, I need you to call me. I could see it was a battle for him to tell me, but I could see that he cared. He knew it was a big hit. I knew it wasn't the end of the world, but I wasn't in a good place.
That night at home I Googled how many women in Australia have HIV and I'm like - so that's it. That's the pool I've got to find someone. It was not my best night.
(Anth) You're both clearly in a better place now. How did that happen? Can you talk us through it?
(Jack) Yeah, so when I got diagnosed, I didn't know how long I'd had HIV. I honestly thought I was dying and I was fuck'n terrified. I thought oh shit, the doctor was gonna say, “Look, I've studied your results and you've got six months.” But he had this warmth and kindness about him, like it was no big deal. He said, “You’ll be okay, you're likely to be undetectable, you won't pass HIV on.” He was so confident in the treatment.
I asked if I had to tell anyone else, and he said, “No, but let's cross that bridge when we come to it.” I suggested I should quit smoking and he said, “Yes, but maybe not right now, because you're going through a lot.” He made me feel safe.
After that experience I started going to therapy and accepting whatever support was on offer. I'd never done that before. It was massive for me. I stopped lying to myself, and I felt like a burden lifted from my shoulders. It took time of course, and I went through some intense years of therapy, dealing with the grief of giving it to someone else. The years I spent in fear had a toll on my mental health, but eventually my life started to get better. I got more comfortable with my diagnosis. I met you guys and other straight people with HIV.
Then I met someone, and I knew it was safe to have sex with her because my virus was undetectable and I was getting routine checks. Then I wanted to tell her, because I really liked her, but I thought she might freak out. I remember talking to you about it, Anth. I also asked my doctor for advice and he suggested bringing her in for a conversation with him, which was brilliant.
I thought I should tell her in public, for my own protection, (laughter). I thought it was going to be horrific but she was amazing. I explained I was perfectly fine and that she wasn't at risk. I came prepared with official fact-sheets on HIV and stuff. And then we went out for dinner. The next day we met with my doctor and he reassured her.
Telling my partner was another weight lifted from my shoulders. I think she respected that I trusted her with something about me, that I didn't share unless the person was extremely important to me. She's now my wife.
HIV is not a thing I even think about much. I don't mind taking a pill every day. It sounds weird, but it's had a positive impact on my life. It led me to reassess the type of person I want to be, and it forced me to face some of the issues I was avoiding. It has made me a better person.
(Danny) It's so good hearing that side of the story mate. People don't get to hear about the positive change that diagnosis can bring. It can bring you closer to yourself.
(Jack) I think that's right. It’s such a traumatic thing at the time, but it led me to do some work on myself. I was broken, but I built myself up to be the best person I can be.
(Anth) I try to let other guys know that for many women, HIV is not a deal-breaker.
(Danny) Women are often very empathetic. It's not easy to tell them, but they generally listen, and give you a chance to explain. Stuff like U = U, and how two positive people can make a negative baby.
(Jack) My wife and I have hardly spoken about HIV in three years. We don't need to. Only a select few people in my personal life know. The bit I found challenging, when dating, is knowing the right time to share my information. I don't think there's a recipe. It's up to the person, and it's different for everyone.
(Danny) I've been with my partner now for a couple of years, but the girls I used to date would be familiar with the grim reaper and hold some stigma towards HIV. I got to a point where I felt sorry for them, I used to hate watching their faces go white, but they would hear me out. The few times I've had to do it, they would listen. By the time I finished, they were back on board. All they needed was up to date information.
(Anth) Danny, I've noticed you live a very wholesome life now. No sugar, no alcohol ...
(Danny) Yeah, I try to stay on the straight and narrow. I haven't had a drink in nearly seven years. HIV was never the problem for me, it was my drug use. I made a pact with myself to live drug-free for 2 years. Which I did. When the two years was up I did a bag of cocaine on the first night (laughter), but I've still never had a drink.
I do try to stay healthy. I'm always gonna have a battle with drugs. I sometimes can't help myself, but I try to do other things right.
(Anth) Any advice for a heterosexual man in the early days of an HIV diagnosis?
(Jack) My advice would be to reach out to healthcare professionals. Take everything on offer. Meet other people living with HIV. You learn a lot from them. Go to therapy. Go to AA and NA. Your life can change for the better very quickly. HIV was a big deal for me, for a while, but now I don't think much about it. Instead, I'm thinking about, how the blinds in my living room are falling down.
Meeting other heterosexual men is valuable. You learn a lot when you listen to each other. You see how other guys manage. I used to love the small gatherings of straight guys. I remember being terrified going to the first one, but then I started looking forward to them.
It's quite a lonely path in the beginning. I felt so much stigma and shame, like I had a dirty little secret I didn't want anyone to know. That meant walking through certain doors alone, but that was the price. To meet other people like me, who had walked the same journey was really valuable.
(Danny) I've learned to be open to vulnerability. Not with everyone but with certain people, certain friends, certain situations. I think that's helped me a lot. It can be so hard for straight guys, they can internalise the stigma and struggle to let it out.
It's important to remember you're not gonna win every person over. You're gonna experience stigma and rejection. But that says more about them than it does about you.
In the hetero community, we don't hear about HIV. Jack, I loved hearing you say that learning facts like U=U was a weight off your shoulders. How the hell would you know what U=U is as a straight guy? All the posters are like, 2 gay guys saying, “Let's get tested”. It's a problem that in the hetero community testing is not promoted at all.
But that’s another thing. I have met so many amazing people that I would not have ever met without having HIV. As a heterosexual man, getting insight into a different world - the gay world and queer people and trans people. Without HIV I wouldn't have had that, and I think it's a great privilege.
(Jack) Looking back I wish I’d gone to a doctor sooner and had an honest conversation with them. It would have saved me a lot of heartache. My advice would be this – HIV is treatable and not as bad as the stigma would have you think. Try not to internalise the stigma that comes with it. It doesn't have to be a big deal.
If you're a hetersexual man living with HIV, you can request one-on-one support by contacting Living Positive Victoria. You can also check out the national advocacy network hetMAN.
Mpox: the facts
by Caleb Hawk
With a majority of the world reporting mpox cases (formerly known as monkeypox), it remains another important factor to consider when travelling, and it disproportionately affects people living with HIV. This explainer piece takes a deep dive into what mpox is, how to recognise symptoms and seek treatment, as well as an account of a person living with HIV who has contracted mpox.
In 2022, a global outbreak saw more than 120 countries report cases of mpox (formerly monkeypox). Following the swift rollout of community awareness campaigns and vaccination clinics, Australia was quick to get the spread under control, finishing the year having had a total of 144 mpox cases. The following year, the country only saw 26 cases with several states and territories recording no new cases. That all changed in April 2024. In the last six months, Australia has seen nearly ten times the number of cases of mpox, and this year’s outbreak has started to look a little different.
As mpox continues to spread going into the summer season, staying informed is more important than ever. Awareness, vaccination, and prompt testing are crucial steps to preventing and managing mpox effectively.
What is Mpox?
Mpox is a viral infection caused by the monkeypox virus, which is related to the smallpox virus. Mpox is usually a self-limiting disease, meaning the body will naturally clear itself of the virus, with symptoms lasting from 2 to 4 weeks. For people who are fully vaccinated that acquire mpox, symptoms can be very mild and a noticeable rash or lesions are less likely to occur. However, among individuals who have been vaccinated, common symptoms reported include:
- proctitis (inflammation of the rectum)
- stomach cramps
- increased or constant need to go to the toilet
- severe lower back or body pain
- sore throat and/or mouth ulcers
- painful urination
Globally, there are two distinct clades of the virus — Clade I and Clade II. The current outbreak in Australia only involves Clade IIb.
While the mpox outbreak in Australia has almost exclusively moved through the sexual health networks of gay, bi, and other men who have sex with men – this year Australia has started to see a small number of cases amongst women. Approximately 20-23% of mpox cases in Australia this year have been amongst people living with HIV. While there is no evidence to suggest that people living with HIV are more susceptible to acquiring mpox, there is some data emphasising the importance of vaccination amongst people living with HIV.
Vaccination
Vaccination is the most effective tool we have to limit the risk of a severe mpox infection. The JYNNEOS vaccine is available in Australia and is safe for people who are immunocompromised, including those with HIV.
A person begins to build protection in the days and weeks after their first dose, but it takes two weeks to reach the highest level of protection following each dose. There needs to be a minimum of 28 days between the first and second doses. Waiting longer than 28 days does not reduce the vaccine’s effectiveness. If you received your first dose more than 12 months ago, you can still receive your second dose now without restarting the vaccination process.
At this stage, there is not sufficient evidence to recommend booster shots of the mpox vaccination, but it remains to be seen if this may change in the future.
How and Where to Get Vaccinated
Mpox vaccines are available at no charge to everyone regardless of their Medicare status. Some vaccination sites may ask you to bring a Medicare card along to your appointment. Whilst the vaccine is free of charge, consultation may not be. Speak to clinic staff to verify any consultation related fees.
Mpox vaccination is available at sexual health clinics, GPs, and a growing number of pharmacists. One of the most complete listings can be found at: https://emen8.com.au/find-a-service/
Why Mpox Matters for People Living with HIV
Unvaccinated people living with HIV, especially those with a low CD4 count or untreated HIV, are at higher risk of experiencing severe mpox symptoms and complications. Studies from the 2022 outbreak found that individuals with compromised immune systems were more likely to have prolonged illnesses and worse outcomes.
Symptoms to Watch For
Mpox symptoms typically appear within 7 to 14 days after exposure but can range from 1 to 21 days. Common signs include:
- Fever and chills
- Headache and muscle aches
- Swollen lymph nodes
- Fatigue
- Rash or lesions (often painful) that can appear on the face, hands, feet, chest, genitals, or anus
For people who are fully vaccinated, symptoms may be milder, and a noticeable rash or lesions are less likely. However, among vaccinated individuals, symptoms may include:
- Proctitis (inflammation of the rectum)
- Stomach cramps
- Increased or constant need to use the toilet
- Severe lower back or body pain
- Sore throat and/or mouth ulcers
- Painful urination
Because many mpox symptoms resemble other STIs (e.g., herpes), it’s important to contact your GP or local sexual health clinic and explain your concerns. Let them know about your symptoms when you make an appointment.
Testing and Treatment
If you suspect you have mpox, testing is essential for early diagnosis and treatment. Testing is available at many clinics and health centres, and it’s free regardless of your Medicare status. Early diagnosis can help prevent severe illness, especially for people living with HIV.
Treatment Options
Most cases of mpox resolve on their own, but some treatment options are available for people with severe cases. If you’re living with HIV, discuss your options with your healthcare provider.
How Mpox is Transmitted
Mpox spreads through close physical contact, particularly sexual or intimate contact. The virus can be transmitted through:
- Bodily fluids (e.g., fluid, pus, or blood from lesions)
- Scabs
- Saliva (from ulcers, lesions, or sores in the mouth)
What to Do if You Suspect Mpox
If you have symptoms, seek medical advice and testing immediately. Call ahead before visiting a clinic, wear a mask, and cover any lesions. You may need to self-isolate to prevent spreading the virus.
Steps to Protect Others
If you’re diagnosed with mpox, there are a number of steps you can take to limit the risk of passing it on to others, including:
- Refrain from close or intimate contact until symptoms clear
- Cover lesions and wear a mask if you have oral symptoms
- Practice hand and respiratory hygiene
- Avoid sharing personal items (e.g., towels, clothing, utensils)
- Disinfect shared spaces like bathrooms
Mpox and HIV: Key Considerations
People with well-managed HIV on antiretroviral treatment are not at greater risk. However, those who are immunocompromised due to untreated HIV may experience more severe mpox. If you’re unsure about your HIV status, getting tested is important.
Staying Informed and Protected
With over 400 cases reported in Victoria in 2024, awareness, vaccination, and prevention are key. By understanding how mpox spreads and taking steps to protect yourself, you can help reduce the risk to yourself and your community.
Lived experience
Keiran is a 46 year old man living with HIV who acquired mpox in mid 2024 after a doctor at the Melbourne Sexual Health Clinic swabbed a lesion on his back. He had already received two doses of the vaccine at this point.
At first, Keiran's symptoms, which lasted two weeks, were quite mild. He says,
I had a runny nose and a sore throat which lasted a few days and felt a bit lethargic for the first week. Then when the second week started I had an uncomfortable feeling in my ass, which I went back to the clinic and learned I had some lesions pop up there, which then led to proctitis, [...] the swelling of the anus, making it agony to go to the toilet. This lasted for three days and was one of the most painful things I have endured.
Aware that being HIV positive can make the infection more severe, he sought the advice of his doctor who said that being on antiretroviral treatment and double vaccinated was the best way to protect himself.
Since then, Keiran has said that the experience has has been a good teaching tool in his role as a Health Promotion Officer with Thorne Harbour Health and says that it has "led to a more cautious approach to casual sex as I can safely say I never want to catch Mpox again. It was horrible."
For more information on vaccination sites, testing options, and prevention tips, head to: thorneharbour.org/mpox
Artist profile
David is a photographic artist whose practice focuses on communicating queer culture and experiences through the composition of surreal still-life imagery. His visual constructions play with the symbolism embedded in everyday objects and invites audiences to interrogate queer social norms.
David currently works in the commercial industry, honing his eye for detail, exploring his newfound interest for styling and art direction, and adopting a culturally nuanced approach to his imagery.
Artist statement
Ad Homonem is a surrealist depiction of my experiences navigating the gay dating scene as a person of colour. Using still-life imagery loaded with symbolism and pop-culture references, I explore and poke fun at the quirks, intricacies and struggles of dating while bringing to light the toxicity pervasive within the queer community. Each image expresses an internal dialogue in which I question these cultural norms while pondering on my own identity.
This series is a love letter to my community, an acknowledgement that we are not without our flaws and an unapologetic celebration of my identity as a gay man.
Find out more about David's work here and on his Instagram (@_davidthai).
Living Positive Victoria acknowledges the Traditional Owners of the land where we work and live. We pay our respects to Elders past, present and emerging. We celebrate the stories, culture and traditions of Aboriginal and Torres Strait Islander Elders of all communities who also work and live on this land.
Poslink+ Quarterly is the seasonal newsletter of Living Positive Victoria and provides readers with the latest HIV treatment and service information, personal stories of living with HIV and helpful advice on maintaining a healthy lifestyle. Click below to subscribe and read previous issues.
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