What Are Early Signs of HIV in Men and Women?

HIV, or human immunodeficiency virus, is a sexually transmitted virus that spreads through exposure to certain body fluids—like genital secretions or blood. [4] HIV transmission can also occur from a mother to a child during pregnancy, childbirth, or breastfeeding. [5]

HIV attacks and impairs the body's immune cells, which weakens the immune system and can eventually progress to acquired immunodeficiency syndrome (AIDS) if it isn't treated. [6] AIDS can be a life-threatening condition, particularly if HIV treatment is not initiated promptly, which is why HIV testing is crucial for protecting your health. [6]

HIV infection passes through an earlier stage before the development of AIDS: acute HIV, the period right after the infection begins. If untreated, the infection progresses to chronic HIV (which may or may not have noticeable symptoms) and ultimately AIDS. [6]

How long does it take to show symptoms of HIV? Some people experience flu-like symptoms, like muscle aches or joint pain, at the start of an HIV infection. These early HIV symptoms usually develop within 2 to 4 weeks in an infected person and may last anywhere from a few days to a few weeks. [7] This early stage of the viral infection is known as an acute HIV infection. [1]

Common symptoms that may manifest during this time if you contract HIV include [8]:

• Fever – What's usually the first sign of HIV for an HIV-positive person? Fever is at the top of the list—it's one of the most common initial signs of an HIV infection. You may also experience headaches.
• Fatigue – Wondering why you are feeling so tired all the time? Those who feel fatigued early on in the HIV infection might feel winded or out of breath while walking or performing daily tasks.
• Skin rash – Skin rashes can occur as both early and later symptoms of HIV. An HIV rash can be itchy, reddish, and painful. In some cases, the skin rashes look like boils that are itchy with pink breakouts. The HIV rash can also appear as a flat red area on the skin covered with small bumps.
• Swollen lymph nodes or swollen glands, mainly on the neck – Swollen lymph nodes develop when your body fights infections. Lymph nodes can swell in the neck, armpits, and groin—and lead to aches and pains.
• Weight loss – Flu-like symptoms and digestive distress can result in weight loss for many in early HIV onset.
• Sore throat and cough – A sore throat and a severe, dry cough can occur, as well. Many people with HIV also find mouth sores or ulcers that are painful to the touch. If you have an HIV-related sore throat, or other symptoms related to HIV, it's best to consult a healthcare provider to learn what steps to take next.
• Chills or night sweats – Night sweats can happen both as an early and later HIV symptom.

It's worth keeping in mind that the most common symptoms associated with the early stage of HIV can also be caused by other health conditions—not just HIV.

In other words, if you're experiencing these symptoms, it doesn't necessarily mean that you have HIV. STI testing and consulting with your healthcare provider can be helpful next steps to take to rule out HIV as the cause of your symptoms.

Symptoms of HIV can vary widely from person to person, regardless of the affected person's gender. HIV progresses through several stages in the course of its manifestation [1]:

• Acute HIV infection
• Chronic HIV infection
• AIDS

At the early or acute stage of infection, HIV usually presents similarly in both sexes with flu-like symptoms. [1] However, people assigned female at birth and people assigned male at birth who are HIV-positive may notice distinct reproductive signs and symptoms in the course of living with the illness.

HIV Symptoms in Women and People Assigned Female at Birth

Symptoms of HIV in women can manifest in several prevalent reproductive health conditions. The most common ones include [9]:

• Menstrual irregularities – Amenorrhea (absent period), skipped periods, and menstrual cycle irregularity are common in women who have HIV.[9] You may also notice changes in your menstrual blood flow (either heavier or lighter bleeding) or exaggerated symptoms of PMS. [9]
• Vaginal yeast infections (vaginal candidiasis) – Recurring vaginal yeast infections—defined as having 4 or more yeast infections in a single year—are highly common in women diagnosed with HIV. [9] They also tend to be more resistant to treatment, particularly in progressed cases of HIV. [9]
• Bacterial vaginosis (BV) – Bacterial vaginosis signifies a disturbance in the bacterial cultures in the vagina. It's very common in women with HIV, and the infection can make it much more difficult to treat. [9]

In addition to these reproductive concerns, women with HIV have a higher risk of developing several other reproductive health conditions. These include [9]:

• Cervical cancer
• Pelvic inflammatory disease
• Abnormal pap smear results
• Genital ulcers

If you have HIV as an older woman, you may also notice earlier-onset menopause or more severe menopausal symptoms. You may also be at higher risk of developing osteoporosis (bone density loss). [9]

HIV Symptoms in Men and People Assigned Male at Birth

The main reproductive concern for men carrying HIV is secondary hypogonadism.[10]

Hypogonadism is a hormonal condition where the body can't produce sufficient testosterone on its own. Secondary hypogonadism can be one of the symptoms of HIV in men if undiagnosed, though it's also possible to develop it from a number of other health conditions. [10]

It's currently estimated that around 20% of men diagnosed with HIV have hypogonadism. [3] It can present with a broad range of symptoms; these tend to vary depending on your age.

If you're an adult male living with hypogonadism, you may notice [10]:

• Low energy or fatigue
• Low mood or depressive symptoms
• Low libido
• Sexual dysfunction
• Fertility issues
• A decrease in muscle mass
• A decrease in hair growth (face and body)
• Extra breast tissue on the chest

Hypogonadism may also result in osteoporosis, which is estimated to impact as many as 30% of people with hypogonadism caused by HIV. [3] Healthcare providers will typically treat this hormonal disorder with hormonal therapy. [10]

According to the Centers for Disease Control and Prevention (CDC), people who engage in unprotected sex, have multiple sexual partners, or use intravenous drugs are at an increased risk of contracting the HIV virus.

In addition, individuals who have a sexually transmitted infection (STI), have a history of STIs, or are sexually active with someone who is HIV-positive are also at risk. It's important to get tested for HIV if you are at risk or think you may have been exposed.

According to the CDC, everyone between the ages of 13 and 64 should get tested for HIV at least once. If you have risk factors, you should get tested at least once a year. You should consider annual HIV testing if any of the following apply to you:

• You're a man who has had sex with another man
• You've had anal or vaginal sex with someone who has HIV
• You've had more than one sex partner since your last HIV test
• You've shared needles, syringes, or other drug injection equipment
• You've exchanged sex for drugs or money
• You've been diagnosed with or treated for another STI, hepatitis, or tuberculosis (TB)
• You've had sex with someone who has done any of the above, or you don't know their sexual history

Sexually active gay or bisexual men may benefit from more frequent testing — every 3 to 6 months. Pregnant people should get tested for HIV during each pregnancy.

Keep in mind that no HIV test can detect the virus immediately after exposure. This is called the window period — the time between exposure and when a test can reliably detect HIV. If you test negative shortly after a potential exposure, test again once the window period has passed.

It's also worth knowing the symptoms of AIDS, the most advanced stage of HIV, which can develop if HIV goes untreated. AIDS symptoms may include:

• Rapid weight loss
• Recurring fever
• Night sweats
• Lethargy
• Prolonged swelling of the lymph glands in the armpits, groin, or neck
• Chronic diarrhea
• Sores of the mouth, anus, or genitals
• Pneumonia
• Memory loss
• Depression
• Red, brown, pink, or purplish blotches on or under the skin or inside the mouth, nose, or eyelids

If you're experiencing any of these symptoms and have had potential HIV exposure, get tested as soon as possible.

HIV treatment has come a long way in recent years, allowing those with the virus to live longer, healthier lives. While there is currently no cure for HIV, antiretroviral therapy (ART) can reduce the amount of virus in your body to undetectable levels — meaning a test can't detect it. Reaching an undetectable viral load is the primary goal of HIV treatment, and most people can achieve this within six months of starting medication.

All people diagnosed with HIV should start treatment as soon as possible, regardless of how long they've had the virus or how healthy they feel. Delaying treatment allows HIV to continue damaging the immune system and increases the risk of progressing to AIDS and transmitting the virus to others.

Types of HIV Treatment

There are two main forms of HIV treatment:

• Pills – Recommended for people just starting HIV treatment. Many FDA-approved single-pill and combination options are available and taken daily.
• Long-acting injections – Given once a month or once every two months, these shots may be an option for adults who have already achieved an undetectable viral load and have no history of treatment failure.

Benefits of Treatment

Staying consistent with HIV treatment offers significant benefits beyond personal health:

• Prevents progression to AIDS – ART keeps the immune system functioning and reduces the risk of life-threatening complications.
• Prevents transmission – If you maintain an undetectable viral load, you cannot transmit HIV through sex. This principle is known as Undetectable = Untransmittable (U=U).
• Reduces drug resistance – Missing doses can allow the virus to mutate, making it harder to treat over time.

Monitoring Your Health

Once on treatment, your healthcare provider will monitor your progress through regular blood tests, including a CD4 count (which measures immune cell levels) and a viral load test (which tracks the amount of HIV in your blood). These help determine whether your treatment plan is working and whether any adjustments are needed.

For those at high risk of exposure who have not yet contracted HIV, pre-exposure prophylaxis (PrEP) is a highly effective preventive medication that significantly reduces the risk of infection.

While HIV is a lifelong condition, the acute stage of HIV infection is the most responsive to treatment. By understanding early signs of HIV in men and women, you can take proactive HIV prevention measures and get tested.

Fortunately, you can test for HIV discreetly and in the privacy of your own home with our At-Home HIV Test Kit. Only a small sample of blood is required (collected via a simple finger prick), and your results are easy to view on our secure, online platform.

If you do test positive for HIV, be sure to mention this as soon as possible to your healthcare provider and learn from them what HIV medicine and/or HIV prevention treatments they may recommend.

You can also opt for sexual health testing year-round through the Everlywell+ STI testing membership, giving you easy access to a wide of variety of STI test options.