Celebrating Pride abroad?

Be aware of health risks at international Pride events

• This updates the news item of 04 May 2023

There are a number of events celebrating Pride worldwide throughout 2023 - all festival goers, including lesbian, gay, bisexual and trans (LGBT) travellers are encouraged to protect themselves against illnesses, and other infections spread by close person-to-person contact, such as mpox (monkeypox), HIV, gonorrhoea and other sexually transmitted infections (STIs).

New sexual partners and unprotected sex are relatively common for travellers, increasing the possibility of STIs. Sexual risk taking abroad may also be linked to alcohol intake [1]. There is increasing evidence that gonorrhoea is becoming untreatable due to increasing drug resistance [2, 3]. This could make it harder to control gonorrhoea in the future.

Advice for travellers

Before you travel

If you are celebrating Pride internationally, make sure you have comprehensive travel insurance.

If you are travelling to mainland Europe, apply for a UK Global Health Insurance Card too. This helps you access emergency state healthcare at a reduced rate and may help you get free emergency care in some European countries.

Remember, while many countries now do not have COVID-19 border health measures, some may still have COVID-19 restrictions and testing requirements. Check the Foreign, Commonwealth and Development Office (FCDO) travel advice for your destination.

See our Country Information pages to check health risks, prevention advice and vaccine recommendations for your destination. If appropriate, make an appointment with your practice nurse, pharmacist, sexual health clinic or other healthcare provider for vaccines and health advice before you go.

Make sure you are up to date with any destination-specific travel vaccines and all routine UK vaccines such as COVID-19, diphtheria, tetanus, polio (DTP) and mumps, measles, rubella (MMR) vaccines. Consider having STI vaccines such as those that prevent human papillomavirus (HPV), hepatitis A and B viruses. Outbreaks of hepatitis A have been linked to Pride in Europe in the past [4, 5].

The NHS previously offered a countrywide vaccination schedule to people most likely to be exposed to mpox. This included some healthcare workers, some men who are gay, bisexual or have sex with other men and people who had close contact with someone with mpox. This nationwide vaccine programme ended in July 2023. Vaccination is still currently available in London: find an mpox vaccination site.

If unprotected sex is likely, discuss HIV pre-exposure prophylaxis/prevention (PrEP) with a health professional before you travel. If appropriate, make sure you have access to contraception.

While you are away

• Follow good hygiene rules to protect yourself and others from respiratory infections: cover your nose and mouth when you cough or sneeze, wash your hands and clean your surroundings.
• Many infections can be spread by contaminated food and water- be careful what you eat and drink and follow basic food hygiene rules.
• Some infections, like hepatitis A and Shigella, are spread via contaminated food and water, but can also be passed on by direct contact with an infected person. This includes sex involving anal contact or contact with faeces. Unlike hepatitis A, there is no vaccine to prevent Shigella. More information about avoiding sexual spread of hepatitis A and Shigella is available.
• Always be aware of your risk of STIs, carry condoms and follow safer sex advice.
• In some countries, insects and ticks can spread infections - be aware of your risk and protect yourself by following bite avoidance advice.

A significant number of mpox cases in 2022 were reported by gay, bisexual and other men who have sex with men (GBMSM) [6, 7]. If you are in these groups, it is particularly important to be aware of symptoms and how you can reduce your risk of infection.

Mpox virus does not usually spread easily between people, but it can be passed on by:

• direct contact with mpox skin lesions or scabs.
• the respiratory tract or mucous membranes (eyes, nose or mouth) from coughing/sneezing of an individual with an mpox rash.
• contact with items used by a person who has mpox, such as clothes and bedding [6]. Close contact with infected animals, especially rodents, is also a risk.

If you are concerned about mpox or if you notice a rash, blisters or lesions, particularly if you have recently had a new sexual partner, or you have other symptoms such as a fever, headache, chills, muscle/back ache, swollen glands (lymph nodes) or extreme tiredness:

• limit your contact with other people [6, 7].
• get medical advice locally if abroad. Call ahead before going to a healthcare facility. If you are unable to ring ahead, tell a staff member as soon as you arrive that you are concerned about mpox.
• follow local public health advice.
• ask a health professional if you are fit to travel or not.
• in some countries, travellers with mpox symptoms, or who are considered a close contact of someone with mpox, may need to self-isolate or may be admitted to hospital or put into government quarantine [6].

When you return

If you have a fever, flu like illness, persistent or bloody diarrhoea or any other unusual symptoms, get urgent medical help, explaining that you have travelled abroad recently.

Call NHS 111 or a sexual health centre immediately if you have a rash with blisters. Do not go to a sexual health clinic without contacting them first. Stay at home and avoid close contact with other people until you have been told what to do [8].

If you are symptom free, but had sex without a condom or think you might have been exposed to an STI, get advice from a sexual health clinic as soon as possible.