HIV and travel: the world may not be your oyster when you roam openly as HIV-positive.

Travis Sherer isn't willing to risk being possibly denied entry to Ghana, Mali, Senegal, Togo, or Burkina Faso because of being HIV positive when he begins a four-month visit later this year. The New York City resident plans to ship his antiretroviral medications to either the U.S. embassy or his hotel in his first destination country to avoid revealing he is HIV-positive at customs and possibly being turned away because of it. "I'm quite nervous about it," he says.

Sherer's longer-than-average stay in Africa makes his situation unique, AIDS experts say. Generally, few countries prevent HIV-positive adults from short-term visits. "I've never experienced a problem because I am HIV-positive," notes William W. Rydwels of Chicago, who has visited 13 nations in Europe, Asia, Africa, and South America while infected. "I am very open about it, since if I'm going to have a problem, I want it up front, not while I'm enjoying my travel experience."

Even nations with the strictest HIV entry bans, including Syria and Uzbekistan, don't require proof of a negative HIV antibody test for visitors staying less than 15 days. A handful of others, including many former Soviet republics and some Middle Eastern countries, impose HIV restrictions only on visitors staying longer than one month; about 15 more have bans that kick in for tourist stays longer than three mouths.

But just because a nation's official policy permits short-term visits, it doesn't mean entry is guaranteed or that lengthy holdups at customs aren't possible, says Frenk Guni, MD, senior associate for international activities at the National Association for People With AIDS, "You can face delays and a lot of questions in some countries if you're carrying antiretroviral drugs--especially a large amount of drugs--into customs," he warns.

Even a customs agent in a bad mood can delay or deny entry to HIV-positive tourists, adds Michelle Lopez, coordinator of the Access to Health Care program at New York's Community Healthcare Network. And some AIDS officials expect more intense scrutiny of HIV-positive Americans as part of growing anti-American sentiment in the wake of the U.S.-led war-in Iraq.

Unfortunately there's little government help in identifying where customs problems may be likely--or even countries with official HIV travel restrictions. The U.S. State Department maintains two official Web sites (www.travel.state.gov/HIVtestingreqs.html and www.travel.state.gov/foriegnentryreqs.html) that list known entry requirements, but the most recent online information is dated June 2003. Phone calls, e-mails, and written letters to the State Department of individual assistance are unlikely to be returned.

Even many gay groups and AIDS service organizations have little expertise in advising HIV-positive travelers. Instead, HIV-positive individuals like Lopez tend to share their personal experiences and pass along stories of HIV-related travel disasters gleaned from friends, colleagues, and agency clients.

Because of the lack of official travel recommendations, Rhonda Goldfein, executive director of the AIDS Law Project of Pennsylvania, advises seropositive tourists to contact U.S. embassies in destination countries or those nations' embassies and consulates in the United States with questions. "Get the information you need from the comfort of your own living room and not when you're already at a border," she advises.

But there are some simple steps all HIV-positive tourists can take regardless of their destinations to minimize chances of undue customs delays or outright deportation.

* Look healthy. Travelers who appear to be ill are likely to be targeted for indepth questioning or inspections, says Lopez.

* Be discreet and polite, advises Hayley Gorenberg, director of Lambda Legal's AIDS Project. "Don't draw any undue attention to yourself" that could cause customs officials to pull you aside.

* Don't advertise the fact that you're HIV-positive. "It pains me to have to give that kind of advice," Goldfein says, "but you might not want to wear an ACT UPT-shirt." Gay pride items should be similarly avoided because foreign customs agents may equate open homosexuality with AIDS.

* Keep your anti-HIV medications in their original bottles, and do not attempt to hide the containers. "If you're hiding them, customs officials may think they contain contraband and may hold you to verify that they are permitted into the country," Guni says.

* Take a list of all your medications, including brand-name designations and their generic equivalents. If a customs agent doesn't recognize a drug name, it may be confiscated or the traveler carrying it into the country may face lengthy questioning, notes Lee Klosinski, who is HIV-positive and is the director of programs at AIDS Project Los Angeles.

Keep a positive attitude. Chances are that, with a little advance planning, you'll experience few--if any--complications, says Jimmy Mack, an HIV positive New York native who's traveled throughout Europe and the Caribbean. "My philosophy on the whole issue is that it's not an issue, so I don't present it as one," he states simply. "And I've never had any problems over the years of extensive travel."

Klosinski agrees and doesn't hesitate to recommend the advantages of overseas jaunts for HIV positive people in good health: "Travel is good medicine. It's fun, it's good for you, and I love it."

HIVers not welcome

Although numerous countries require proof of negative serostatus for long-term visitors (people staying one month or longer), the countries noted have policies or practices to deny short-term tourists entry if their HIV-positive status is disclosed.

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The World's Worst Place for HIV-positive Travelers

Reluctant HIV-positive travelers who invite foreign HIV-positive friends and relatives to visit them in the States should reconsider such a plan, AIDS experts say. A law pushed through Congress by antigay farmer U.S. senator Jesse Helms in 1993 established the United States as the world's most restrictive nation for HIV-positive visitors. Virtually all HIV-positive people are officially barred entry, even for short visits. Special exemptions are possible, but these are rarely given, particularly in the heightened security atmosphere of post-9/11, AIDS experts say. While the letter of the law is rigorously applied to long-term visitors and intended immigrants, it's only sporadically enforced for tourists, according to the online AIDS resource Aegis.com, But HIV-positive visitors, regardless of their planned length of stay or nation of origin, can be legally turned away at the border, and it does occasionally happen, says Lee Klosinski, director of programs at AIDS Project Los Angeles: "I would be much more apprehensive in coming here than I would be about traveling almost anywhere else."

Adams is the senior editor for HIV Plus magazine and a contributing editor for The Advocate.