Understanding the first signs of HIV and why getting tested regularly is important
- The first signs of HIV may include a fever, muscle soreness, fatigue, or other flu-like symptoms.
- Some people experience no initial symptoms, which is why getting tested frequently is important.
- The initial stage of infection is known as an acute HIV infection, and it typically occurs two to four weeks after transmission.
With the advancement of treatment and medicine, people with human immunodeficiency virus (HIV) can live long, healthy lives without the risk of transmitting the disease to others.
But to ensure early detection, it's important to understand the first signs of the HIV. Initial symptoms of HIV are similar to those caused by the flu, including fever, fatigue, and a sore throat. These symptoms typically occur two to four weeks after being infected.
However, it can take months or years for symptoms to appear, says Hana Akselrod, MD, MPH, infectious disease physician at the George Washington University.
Important: The first signs of HIV generally get mistaken for the flu, so it's important to get tested regularly, especially if you're sexually active with multiple partners or with someone who is HIV-positive.
Here's what you need to know about the initial and long-term symptoms, testing, and treatment for HIV.
The first signs of HIV
The initial stage of HIV is called an acute HIV infection. Within the first month of being infected with HIV, you may experience flu-like symptoms such as:
- Fever
- Sore throat
- Swollen lymph nodes
- Fatigue
- Muscle aches
- Headaches
- Rash and mouth sores
It may be hard to differentiate the initial symptoms of HIV from the flu or mono. If symptoms are accompanied by rashes and mouth sores, that's usually an indication that the cause is more likely an early stage of HIV than the common flu.
Important: You can only contract HIV by coming in contact with the bodily fluids - such as blood, vaginal fluids, semen and pre-seminal fluid, rectal fluids, and breast milk - of an HIV-positive person. The transmission happens via contact through open wounds, direct injection, or a mucous membrane (mouth, vagina, tip of the penis, or rectum).
It's important to note that HIV symptoms aren't consistent and vary from one person to another, both in type and severity.
"Some people may have varying degrees of symptoms but no significant differences based on gender or race," says Aadia I. Rana, MD, associate professor of medicine under the Division of Infectious Diseases at the University of Alabama at Birmingham.
It's also possible to have HIV and be asymptomatic. In fact, approximately 15% of people living with HIV aren't aware of their status and can unknowingly transmit the virus to others. Some people don't get tested at all due to the misinformation and stigma surrounding HIV.
"This makes it crucial to make testing for HIV a part of normal care - to make it affordable, accessible, and free of stigma - so that everyone who is infected can know their status and be able to take the right steps for their own health and that of their loved ones," says Akselrod.
What are the long-term symptoms of HIV?
"A person who is infected with HIV will often not develop symptomatic disease for several years after their infection," says Rana. If left untreated, HIV can destroy your immune system and progress to its most severe stage, Acquired Immune Deficiency Syndrome (AIDS).
Long-term symptoms of HIV that can indicate the progression to AIDS usually arise about five to 10 years after infection, which include:
- Rapid weight loss
- Loss of muscle control, strength, and reflexes
- Infections, like Candidiasis, toxoplasmosis, tuberculosis
- Headaches and lightheadedness
- Chronic diarrhea
- Shortness of breath
- Chronic pelvic inflammatory disease
- Bleeding from the mouth, nose, anus, or vagina
- AIDS-defining illnesses including certain cancers, such as Kaposi sarcoma, non-Hodgkin lymphoma, and cervical cancer
"Getting other sexually transmitted infections, such as syphilis, gonorrhea, or chlamydia, is a warning sign that someone is also at risk for HIV," says Akselrod. STIs cause the skin to break down, which increases the risk of contracting and transmitting HIV.
Getting tested and treated for HIV
"All adolescents and adults who are sexually active should get screened for HIV as part of their routine primary care," says Akselrod. "Blood tests for HIV are now extremely accurate - both sensitive and specific - and can detect HIV, even within the first two to four weeks after becoming infected."
Here are some tools to help you find HIV testing sites and care services near you:
You can also get tested at sexual health or family planning clinics, your health care provider's office, or other local health centers.
If you test positive for HIV, you'll need to take antiretroviral therapy (ART) to manage your condition. This medicine can lower the amount of HIV in your blood to the point that a test can no longer detect it, which is known as being "undetectable" or having an "undetectable viral load."
Important: Pre-exposure prophylaxis (PrEP) and post-exposure prophylaxis (PEP) both help you avoid contracting HIV, but PrEP is taken by people who may be exposed to HIV in the future whereas PEP is taken by those who were already exposed to HIV within the past 72 hours.
"As long as they take it regularly, the virus is completely controlled and the person can have a normally functioning immune system," says Rana. Being undetectable also means that there is no risk of transmitting HIV to other people.
Insider's takeaway
The first signs of HIV are similar to that of flu, however, some people may not experience any symptoms at all. If left untreated, HIV may progress to AIDS and manifest symptoms such as rapid weight loss, chronic diarrhea, and yeast infections.
It's important to get tested regularly, especially if you are sexually active, to know your status and prevent HIV transmission. If you test positive for HIV, you can control the virus and protect your immune system by taking ART.
"When HIV was first discovered in the 1980s, there was no treatment to stop its progression to AIDS and eventual death," says Akselrod. "Nowadays, ART medication is extremely effective and safe, and people diagnosed with HIV today can expect to live a normal lifespan so long as they are treated continuously."