Celebrating Pride abroad?

Be aware of health risks at international Pride events

There are a number of events celebrating Pride worldwide throughout 2024 - 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 gonorrhoea, HIV, mpox (monkeypox), syphilis and other sexually transmitted infections (STIs).

New sexual partners and unprotected sex are relatively common for travellers, increasing the possibility of STIs [1]. Particularly when attending large international gatherings where sex may occur, or visiting parts of the world where STIs are more common.

Mpox, shigella and drug resistant gonorrhoea [2, 3] are three examples of STIs where travel-related infections are regularly seen.

An increase in cases of extensively antibiotic-resistant shigella infections, mainly in gay, bisexual, and other men who have sex with men (GBMSM) has been reported internationally [4-7]. The international outbreak of mpox that began in 2022 spread to over 100 countries within four months [8].

Gonorrhoea resistance to recommended treatment is common in the Asia-Pacific region, but rare in the United Kingdom (UK). Cases in the UK are usually linked to travel abroad to or from areas with higher numbers of infections [2].

Advice for travellers

Before you travel

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

If you are travelling to mainland Europe, apply for a United Kingdom (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.

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 [9, 10].

In the UK, vaccination was offered to people most likely to be exposed to mpox during the outbreak in 2022. This included some healthcare workers, GBMSM and people who had close contact with someone with mpox. Nationwide Mpox vaccination in the UK ended in July 2023. However, the vaccine 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.

While numbers of mpox cases in the UK reported by GBMSM were significantly reduced in 2023 compared to the peak of the outbreak in 2022, travel-associated cases were still reported [11]. For GBMSM 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, including during sex or intimate contact.
• 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.
• Close contact with infected animals, especially rodents, is also a risk in parts of west and central africa [12].

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 [12].
• 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 (if available) abroad.
• The UKHSA have guidance for people who have been diagnosed with a mpox infection and who have been advised to self-isolate: Mpox (monkeypox): people who are isolating at home.

When you return

If you are unwell with 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.

If you have symptoms and are concerned that you may have an STI or are symptom free but think you might have been exposed to an STI, call NHS 111 or a sexual health centre.

If you have a rash with blisters and are concerned about mpox infection, 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 [12].