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. 2010 May-Jun;17(3):176-81.
doi: 10.1111/j.1708-8305.2010.00400.x.

Anti-retroviral therapy among HIV infected travelers to Hajj pilgrimage

Abdulrazaq G Habib  1 , Murjanatu Abdulmumini, Mahmoud M Dalhat, Muhammad Hamza, Garba Iliyasu
Affiliations
Free article

Anti-retroviral therapy among HIV infected travelers to Hajj pilgrimage

Abdulrazaq G Habib et al. J Travel Med. 2010 May-Jun.
Free article

Abstract

Background: Many countries with high prevalence of human immunodeficiency virus (HIV) infection also have substantial Muslim populations. HIV-infected patients who travel to Hajj in Saudi-Arabia may encounter challenges regarding their anti-retroviral therapy (ART).

Methods: In a cohort study in Nigeria, clinically stable patients on ART who were traveling for the 2008 to 2009 Hajj (Hajj-pilgrims [HP]) were selected and compared with consecutively selected Muslim patients who were clinically stable and traveled to and from distances within the country to access ART (non-pilgrims [NP]). Participants were clinically evaluated and interviewed regarding their adherence to ART pre-travel and post-travel, international border passage with medications and reasons for missing ART doses. Post-travel change in CD4 counts and RNA-PCR viral load were measured. Outcomes were proportion who missed >or=1 dose of ART during Hajj compared with pre-travel or post-travel and failure of ART, defined as decline in CD4 cell counts or high viral load or both.

Results: Thirty-one HP and 27 NP had similar characteristics and were away for (median [range]) 36 days (28-43 days) and 84 days (28-84 days), respectively (p < 0.0001). Those who missed >or= 1 ART doses among HP and NP while away were 16/31 (51.6%) and 5/27 (18.5%), respectively with risk ratio (95% confidence interval [CI]) 2.79 (1.18-6.60). Among HP, the proportions who missed >or= 1 ART doses pre-travel and post-travel were lower than those who missed it during Hajj. Those who failed ART among HP compared with NP were 15/31 (48.4%) and 5/27 (18.5%), respectively with odds ratio (95% CI) 4.13 (1.10-17.21). Reasons for missing ART included forgetfulness, exhaustion of supplies, stigma, spiritual alternatives, or disinclination; five patients were unable to cross airports with medications.

Conclusions: Patients who went on Hajj were more likely to miss medications and to have ART failure due to several reasons including inability to cross borders with medications.

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