HIV Symptoms in Women and Men

What HIV symptoms look like

Some people have a flu-like illness two to four weeks after HIV infection – fever, sore throat, swollen glands, a rash, muscle and joint aches, headache, night sweats, mouth ulcers – that lasts a week or two and goes away. It is called acute HIV, and it is easy to mistake for flu, mono or a cold. After that, HIV usually causes nothing for years while it slowly weakens the immune system. The late signs – rapid weight loss, recurring fevers, drenching night sweats, persistent diarrhea, thrush, pneumonia – are the signs of advanced disease, years after infection, and are rare now that treatment exists.

Why most people have no symptoms

The CDC estimates that about 1.2 million Americans are living with HIV and that roughly one in eight does not know it. Many people never have the early flu-like illness, and those who do rarely connect it to HIV. HIV spreads through blood, semen, vaginal and rectal fluids and breast milk – in practice, mostly through anal or vaginal sex without a condom and through shared injection equipment. It is not spread by kissing, sharing food or toilets, or casual contact, and the risk from oral sex is very low. A test is the only way to know. Symptoms do not shorten the time an infection takes to show up on a test, and having none does not mean you are clear.

What else causes the same symptoms

The early symptoms of HIV are the symptoms of almost any viral illness: flu, COVID-19, mononucleosis, strep throat and a dozen others produce the same fever, sore throat and swollen glands. A rash has countless causes. Nobody can diagnose or rule out HIV from symptoms – only a test can, and only after the window period.

When to see a clinician rather than wait for a test

If you may have been exposed to HIV in the last 72 hours – a condom broke with a partner whose status you do not know, a needle-stick, a sexual assault – go to an urgent care, emergency room or sexual health clinic today and ask about PEP (post-exposure prophylaxis). PEP is a month of HIV medication that can prevent infection, but only if it is started within 72 hours, and the sooner the better. Do not wait for a test result to do this. Call us afterwards and a care advisor will help you plan the follow-up testing. If you have ongoing risk, ask a clinician about PrEP, a daily pill or long-acting injection that prevents HIV. If you are pregnant, HIV testing is part of routine prenatal care, and treatment in pregnancy greatly reduces the chance of passing HIV to the baby.

How HIV is tested, and what the tests cannot tell you

We offer two blood tests. The fourth-generation antigen/antibody test looks for the p24 antigen, a piece of the virus that appears early, and the antibodies your body makes in response; it is the test the CDC recommends for laboratory testing and covers HIV-1 and HIV-2. The HIV RNA test looks for the virus’s genetic material directly and can find infection earlier still. Neither is reliable immediately after an exposure: each has a window period, and a negative taken too early needs to be repeated. PEP or PrEP can delay detection, so tell the care advisor if you are taking either. If a screen is reactive, the laboratory runs confirmatory testing, and no one is diagnosed with HIV on a single screening result. The timing is on our When to Get Tested page, or call (866) 872-1888 and a care advisor will tell you which test and which day.

After a positive result

A positive result is life-changing news, but not the news it once was. A member of our care team calls you the day the result is in, explains it, and arranges a consultation with a physician who connects you to HIV care promptly. Treatment – antiretroviral therapy, often one pill a day – usually starts right away. Within months most people reach an undetectable viral load, which protects the immune system and, kept undetectable, means you cannot pass HIV on through sex: the CDC calls this U=U, undetectable equals untransmittable. Treatment does not make HIV tests turn negative – the antibodies stay – and it does not remove the need for partners to be told and tested; the care team can help with that conversation. A person diagnosed today and treated can expect a near-normal lifespan.