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Southern Alberta HIV Clinic - Clinic Policies: Travelling or Living Abroad for Extended Periods

 

 

Southern Alberta HIV Clinic

Information for Professionals

Clinic Policies: Travelling or Living Abroad for Extended Periods

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Patients Travelling or Living Abroad For Extended Periods

Travelling for HIV-positive patients can be tricky. In addition to the extra preparation needed for taking care on oneself while abroad (e.g., insurance, medication, emergency plans), several countries around the world throw up extra political barriers. According to data collected by the European AIDS Treatment Group, a total of 74 countries have some form of HIV-specific travel restrictions, 12 of which ban HIV positive people from entering for any reason or length of time (including the United States).

Background

The Southern Alberta Clinic pharmacy is increasingly being asked to dispense antiretroviral drugs for a period over four months to our patients that are planning to reside outside of Canada for lengthy periods of time. When dispensing expensive antiretroviral drugs funded by the Province of Alberta, we have to meet certain standards for responsibility (similar to other provincial agencies dispensing provincially funded expensive oral agents such as the Alberta Cancer Board, Alberta Blue Cross and Alberta Province-Wide Services). We also must meet the safety standards appropriate for prescribing antiretroviral drugs.

Visits at a maximum duration of four months are the standard of care for stable HIV patients on low toxicity drugs with documented and durable suppression of HIV replication. Compared to other Alberta government-funded programs, a prescription length of four months is very generous as they insist on more frequent visits even for "stable patients." Visits are designed to check for both laboratory results as well as clinical toxicity in addition to confirming efficacy with ongoing suppression of viral replication. All programs insist on the need for far more frequent monitoring for patients starting therapy or those receiving agents that are potentially highly toxic in long use.

Policy

This policy is for all patients wishing to travel abroad for any extended time beyond the Southern Alberta Clinic standard of care guidelines.

  1. The maximum amount of antiretrovirals dispensed at one time will be four (4) months based on the following criteria (adapted from our 2+1 policy):
    a) Patients that demonstrate close antiretroviral adherence based on timely refills in pharmacy database.
    b) Patients on stable therapy, with undetectable viral loads, CD4 counts over 200 cells/mm3 and no changes in medications for at least one year.
    c) Those who are asymptomatic of any HIV-related illnesses.
    d) Those who have not been hospitalized in the last year.
  2. Blood work must have been completed within the month before travel.
  3. Appointment and approval with a Southern Alberta Clinic physician must be done within the month before travel.
  4. Patients who are not eligible with the above criteria, will be dispensed an amount of antiretrovirals at the discretion of the physician and pharmacist where less than four (4) months medications may be supplied.
  5. Patient must have and maintain a valid Alberta Health Care number. For more information see www.health.alberta.ca/health-care-insurance-plan.html

Patients wishing to be abroad for duration greater than four months must:

  1. Return to Calgary for a medical assessment every four (4) months; OR
  2. Be responsible to do blood work and have a clinical assessment and reports from a reliable laboratory sent to us showing that viral load, CD4 count, LFTs, creatinine and CBC are all within acceptable limits.
  3. Be responsible for transporting or shipping of antiretroviral after we have checked the clinical assessment and bookwork. Having family members carry drugs or company transport the drugs may be an option. The Southern Alberta Clinic cannot mail or courier antiretroviral out of country due to customs and loss issues.
  4. All patients must be seen at the Southern Alberta Clinic within six (6) months to remain on this program OR they must transfer their care to the country of residence.

If you have any questions, contact the Southern Alberta Clinic at
(403) 955-6399.

Download Printable Version

To download a printable version of the Southern Alberta Clinic's policy regarding travel, follow the link below:

Southern Alberta Clinic Travel Policy

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