What Are Early Signs of HIV in Men and Women

It’s important to start HIV medication and treatment as soon as possible after an HIV diagnosis. According to the CDC, early treatment can help people with HIV live nearly as long as those who do not have the virus.

11 Signs of HIV to Know

Unexplained rash, swollen lymph nodes, oral thrush, night sweats, and sudden and unexplained weight loss are all possible signs of human immunodeficiency virus (HIV). Some symptoms appear in the early stage of HIV, while others show up in later stages. However, not everyone will experience the same symptoms at the same stage.

The signs or symptoms of HIV are not always obvious, and most people who have HIV do not exhibit any of them. If you do have early (acute) symptoms, they’re likely to appear in the first month or two after you’ve been infected. They may be similar to flu symptoms, including fever, headache, and fatigue.

These first signs of HIV differ from late-stage symptoms when the virus weakens your immune system. These persistent (chronic) symptoms indicate the progression of illness. They may include diarrhea for over one week, persistent cough, and rapid weight loss.

Illustration by Michela Buttignol for Verywell Health

Fever

Early acute HIV infection (AHI) can cause symptoms similar to the flu, including fever and chills. These symptoms may appear two to six weeks after you’ve been infected, and then go away. If your HIV remains untreated, they may return a few years later.

If you do get a fever, you will likely also have other flu-like symptoms. This is because your immune system is reacting to the virus as it replicates and moves through your system.

What Is ARS?

ARS stands for acute retroviral syndrome. This is the collection of HIV signs and symptoms that occur during acute HIV infection (AHI) when the immune system mounts a defense against the virus as it first enters the body. As many as two out of three people with acute-stage HIV do not know they have it.

Headache and Fatigue

AHI can also cause headaches and fatigue. This is because your body’s initial immune response to the virus generates inflammation.

You may get tired much faster than usual and you may feel out of breath even after light activity. You may experience a persistent headache that can range from mild to severe.

Headache and fatigue can also be symptoms of later-stage HIV.

Swollen Lymph Nodes

Swollen lymph nodes ( lymphadenopathy ) can occur in the early stages of HIV as the body tries to kill the virus.

The lymph nodes of the armpits, neck, groin, or behind the ear may get bigger. Sometimes, the swelling is very noticeable. Swollen lymph nodes may hurt or be tender to the touch.

Even as the other signs of the acute HIV infection go away, swollen lymph nodes can persist in some people for many weeks or months.

Sore Muscles and Joint Pain

Sore muscles and joint pain are common symptoms of many different viral illnesses. This symptom tends to occur alongside the other flu-like symptoms that are common in early HIV, such as fever, fatigue, and headache.

Unexplained Rash

A rash is often the first sign of HIV, but it only appears in two of every five newly infected people.

An HIV rash looks a certain way: large areas of flat, reddened skin peppered with tiny bumps. The rash can be itchy or painful. It often occurs alongside flu-like symptoms.

The HIV rash usually starts two to six weeks after exposure to the virus and will go away within one to two weeks. The rash is widespread and mainly affects the trunk and face, but can also be on the hands and feet.

This photo contains content that some people may find graphic or disturbing.

U.S. National Library of Medicine / National Institutes of Health

If you have a sudden rash with flu-like symptoms two to six weeks after having sex with a partner of unknown HIV status, you should get tested for HIV.

Nausea and Diarrhea

Some people also experience gastrointestinal (GI) symptoms during the early stage of HIV. GI symptoms may include nausea and vomiting and/or diarrhea.

GI symptoms can be present in many other illnesses, but they typically resolve quickly. If you have persistent nausea and vomiting or diarrhea, make sure you stay hydrated and see your healthcare provider.

Oral Thrush

One of the early opportunistic infections in people living with HIV is oral thrush. It is considered “opportunistic” because it takes the opportunity to infect a person when their immune system is weak.

Oral thrush is also called oral candidiasis . It’s caused by a fungus that can invade the inside of the mouth and throat.

People who are relatively healthy can also get oral thrush, but it is a sign that their immune system is breaking down. When a person’s immune system function is poor, the fungus can spread into the lungs and cause pneumonia. It can even spread to the bloodstream.

Having oral thrush does not automatically mean that you have HIV, but it could be a sign that you should get tested if you’re at risk.

This photo contains content that some people may find graphic or disturbing.

Oral thrush (candidiasis) on the upper palate.

Sol Silverman, Jr., D.D.S. / Centers for Disease Control and Prevention

Chronic symptoms of HIV develop as the virus breaks down the body’s immune defenses, leaving it open to infection. During the chronic stage of HIV, many symptoms are non-specific, meaning a person may assume they are due to another cause.

Sore Throat and Dry Cough

Sore throat and dry cough can be symptoms of early HIV infection, but they also appear in later stages of HIV. In later stages, these are persistent symptoms that do not resolve with medications such as inhalers or antibiotics. They are often related to secondary lung infections, which are common in the later stages of HIV.

A persistent cough is always a reason to see your healthcare provider, especially if it’s getting worse over time.

Night Sweats

Night sweats can occur during the acute stage as the body fights the virus and during the chronic phase if there is an opportunistic infection.

Also called sleep hyperhidrosis , night sweats are more than just being sweaty in your sleep—they will drench your clothes and bedding. Night sweats can also soak through these materials and cause shivers.

Drenching night sweats are never considered normal. You should let your provider know if you’re having them.

Night sweats can have causes other than HIV, and some of them are not as serious as others—for example, menopause commonly causes night sweats but many types of cancer can as well.

Sudden, Unexplained Weight Loss

Weight loss is common in people living with HIV during the advanced stages of the disease.

This type of weight loss is more than just a few pounds—it’s a sudden, unexplained weight loss of 10% or more of a person’s body weight, in which both fat mass and lean muscle are lost.

The condition is also called HIV wasting syndrome. It’s not as common today as it once was because antiretroviral drugs keep the virus suppressed and allow the immune system to rebuild itself. Wasting is mainly seen in people who have not been treated for HIV.

The exact cause of HIV wasting is unknown, but it is thought that the constant inflammation caused by HIV makes the body burn energy faster and reduces testosterone levels (which the body needs need to build lean muscle).

Other causes of wasting include malnutrition, chronic diarrhea, tuberculosis, and cancer—all of which require urgent diagnosis and treatment.

A Sexually Transmitted Infection (STI)

If you have a sexually transmitted infection (STI), there is a chance you may have HIV as well. Some STIs like syphilis and herpes cause open sores that make it easier for HIV to get inside the body.

STIs like gonorrhea and chlamydia cause inflammation in the genitals that attract the immune cells (CD4 T cells) that HIV likes to target and infect.

Having syphilis can increase your risk of HIV by as much as 500%. Other STIs can also raise your risk for HIV. You should be tested for HIV if you test positive for any STI.

Only an HIV test can tell you for sure if you have the virus.

Sex Differences With HIV Signs

Biological females and males generally have the same symptoms of HIV, but females may also have frequent yeast infections and irregular periods. Females living with HIV are also at an increased risk of pelvic inflammatory disease and cervical cancer.

Summary

Many people who are HIV-positive do not know they have the virus. The only way to find out for sure is to get tested.

There are some clues that could mean you have HIV, especially if you’re at risk. The first signs of HIV can seem like the flu with symptoms like fever, headache, and fatigue. Sometimes the first sign of HIV is a rash with flat, reddened skin and tiny bumps.

Late-stage symptoms may include recurring night sweats, diarrhea for more than a week, and rapid weight loss. Having another STI may also indicate that you’re at risk for HIV.

Never assume that not having symptoms is the same thing as not having HIV. Not feeling sick does not mean that the virus is “mild” or that your immune system is not being harmed by it. If you are at risk of HIV, it’s important to get tested and treated.

22 Sources

Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.

1. HIV.gov. How can you tell if you have HIV?
2. Manak MM, Eller LA, Malia J, et al. Identification of acute HIV-1 infection by hologic aptima HIV-1 RNA qualitative assay. J Clin Microbiol. 2017;55(7):2064-2073. doi:10.1128/JCM.00431-17
3. HIV.org. Symptoms of HIV.
4. Burns DN, Degruttola V, Pilcher CD, et al. Toward an endgame: finding and engaging people unaware of their HIV-1 infection in treatment and prevention.AIDS Res Hum Retroviruses. 2014;30(3):217-224. doi:10.1089/aid.2013.0274
5. Zhu Z, Zhao R, Hu Y. Symptom clusters in people living with HIV: A systematic review. J Pain Symptom Manage. 2019;58(1):115-133. doi:10.1016/j.jpainsymman.2019.03.018
6. National Library of Medicine. Swollen lymph nodes.
7. Nag D, Dey S, Nandi A, Bandyopadyay R, Roychowdry D, Roy R. Etiological study of lymphadenopathy in HIV-infected patients in a tertiary care hospital. J Cytol. 2016;33(2):66–70. doi:10.4103/0970-9371.182518
8. Lopez-Rios J, Frasca T, Kindlon MJ, et al. Limited knowledge and lack of screening for acute HIV infection at primary care clinics in high-prevalence communities of New York City. AIDS Behav. 2019;23(10):2870-2878. doi:10.1007/s10461-019-02527-3
9. National Library of Medicine. HIV.
10. Klatt EC. Pathology of HIV/AIDS.
11. Patil S, Majumdar B, Sarode SC, Sarode GS, Awan KH. Oropharyngeal candidosis in HIV-infected patients-An update. Front Microbiol. 2018;9:980. doi:10.3389/fmicb.2018.00980
12. Kaur R, Mehra B, Dhakad MS, Goyal R, Bhalla P, Dewan R. Fungal opportunistic pneumonias in HIV/AIDS patients: An Indian tertiary care experience. J Clin Diagn Res. 2017;11(2):DC14-DC19. doi:10.7860/JCDR/2017/24219.9277
13. Aldamova A, Ovsepian Z. Features of the clinical course of invasive Candidiasis in HIV-infected patients. Ann Rom Soc Cell Biol. 2021;25(3):5476-81.
14. Pastor L, Casellas A, Carrillo J, et al. IP-10 Levels as an accurate screening tool to detect acute HIV infection in resource-limited settings. Sci Rep. 2017;7(1):8104. doi:10.1038/s41598-017-08218-0
15. Sax PE, Bartlett J, Bloom A. Acute and early HIV infection: Clinical manifestations and diagnosis. Up To Date. 2019.
16. Qiuwan Z. Atlas of AIDS Co-infection. Walter de Gruyter GmbH and Co KG; 2015.
17. Shaw J, Matin N. Opportunistic infections in HIV. Medicine. 2022;50(5):294-7. doi:10.1016/j.mpmed.2022.02.010
18. Bryce C. Persistent night sweats: diagnostic evaluation. Am Fam Physician. 2020;102(7):427-433.
19. Erlandson KM, Li X, Abraham AG, et al. Long-term impact of HIV wasting on physical function in the Multicenter AIDS Cohort Study. AIDS. 2016;30(3):445–454. doi:10.1097/QAD.0000000000000932
20. Cohen MS, Council OD, Chen JS. Sexually transmitted infections and HIV in the era of antiretroviral treatment and prevention: the biologic basis for epidemiologic synergy. J Int AIDS Soc. 2019;22(Suppl 6):e25355. doi:10.1002/jia2.25355
21. HIV.gov. Syphilis and HIV: a dangerous duo affecting gay and bisexual men.
22. Scully EP. Sex differences in HIV infection. Curr HIV/AIDS Rep. 2018;15(2):136-46. doi:10.1007/s11904-018-0383-2

By Mark Cichocki, RN
Mark Cichocki, RN, is an HIV/AIDS nurse educator at the University of Michigan Health System for more than 20 years.

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What Are Early Signs of HIV in Men and Women?

Medically reviewed on Oct 20, 2023 by Neka Miller, PhD. To give you technically accurate, evidence-based information, content published on the Everlywell blog is reviewed by credentialed professionals with expertise in medical and bioscience fields.

Table of contents

• HIV: A Brief Overview
• Early Signs and Symptoms of HIV
• Does HIV Affect Men and Women Differently?
• Who Is at Risk for HIV?
• Testing for HIV
• Treatment for HIV
• Check for HIV From Home With the Everlywell HIV Test

Looking into early signs and symptoms associated with HIV can feel overwhelming, particularly if you’re worried you’ve contracted it. Early signs of HIV typically overlap between genders: they’re similar to the flu, though they can encompass a broad variety of early HIV symptoms in men and women. [1]

That said, down the line, undiagnosed or untreated HIV can result in reproductive health consequences that impact the sexes differently. Signs of HIV in women frequently include menstrual cycle dysregulation and certain types of vaginal infections. [2] On the other hand, up to 20% of male cases of HIV result in a hormonal disorder known as hypogonadism. [3]

If you’re concerned you may have HIV or any symptom associated with it, the good news is that early detection is the best way to reduce your risk of reproductive and other health complications later. In fact, understanding HIV transmission and the various ways HIV can manifest is a fundamental step in diagnosing and treating HIV properly.

HIV: A Brief Overview

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]

Early Signs and Symptoms of HIV

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.

Does HIV Affect Men and Women Differently?

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 lighter or heavier 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]

n 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]

Who Is at Risk for HIV?

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.

Testing for HIV

If you have had unprotected sex with an HIV-positive partner, it’s important to get tested. You can do this from the comfort and privacy of home with the Everlywell HIV Test.

It’s a good idea to be aware of AIDS symptoms, as well, which can 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

Treatment for HIV

HIV treatment has come a long way in recent years, allowing those with the virus to live longer, healthier lives. Antiretroviral therapy (ART) is the most common treatment for HIV and involves taking HIV medication daily to suppress the virus and prevent it from progressing.

It’s important to start HIV medication and treatment as soon as possible after an HIV diagnosis. According to the CDC, early treatment can help people with HIV live nearly as long as those who do not have the virus.

Check for HIV From Home With the Everlywell HIV Test

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.

1. The stages of HIV infection. National Institutes of Health. URL. Accessed October 9, 2023.
2. How does HIV impact women’s health? HIV.gov. URL. Accessed October 9, 2023.
3. Hypogonadism and bone health in men with HIV – the lancet HIV. November 2020. URL. Accessed October 10, 2023.
4. How is HIV transmitted? HIV.gov. URL. Accessed October 9, 2023.
5. HIV and pregnancy: Protecting mother and child. HIV.gov. URL. Accessed October 9, 2023.
6. HIV and AIDS: The basics. National Institutes of Health. URL. Accessed October 9, 2023.
7. About HIV/AIDS. Centers for Disease Control and Prevention. June 30, 2022. AURL. ccessed October 9, 2023.
8. Early HIV symptoms: What are they? Mayo Clinic. January 11, 2023. URL. Accessed October 9, 2023.
9. How does HIV impact women’s health? HIV.gov. URL. Accessed October 9, 2023.
10. Male hypogonadism. Mayo Clinic. URL. Accessed October 9, 2023.

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