About HIV

The first sign of HIV is usually flu-like symptoms, which can include rash, fever, chills, fatigue, and sore throat.

6 Signs of HIV to Know

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

Updated on October 06, 2022

Anju Goel, MD, is board-certified in internal medicine. She has over 10 years of experience in the California public health system addressing communicable disease, health policy, and disaster preparedness.

Unexplained rash, swollen lymph nodes, oral thrush, night sweats, and sudden and unexplained weight loss are all possible signs of HIV. Having a sexually transmitted infection (STI) isn’t a physical sign of HIV, but it does indicate a greater risk of having HIV as well.

The signs or symptoms of human immunodeficiency virus (HIV) are not always obvious, though. And in fact, most people who have HIV do not exhibit any of them. Signs of HIV can also depend on whether a person is in the new (acute) or persistent (chronic) stage of infection.

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Only an HIV test can tell you for sure if you have the virus. Still, it is important to know about these six common signs and symptoms of HIV, especially if you are someone who is considered to be at higher risk for infection. This article explains each of them.

An Unexplained Rash

A rash is often the first sign of HIV, but it only appears in 2 of every 5 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. Once a person gets the rash, flu-like symptoms are also common.

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 arms, legs, hands, and feet.

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.

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.

What Is ARS?

ARS stands for acute retroviral syndrome. This is the collection of HIV signs and symptoms that occur 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.

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 windpipe, lungs, and even 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.

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.

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.

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:

• An unexplained rash with flu-like symptoms
• Swollen lymph nodes
• Oral thrush
• Drenching night sweats
• Unexplained weight loss of 1O% or more
• Having another sexually transmitted infection (STI)

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.

Frequently Asked Questions

What is usually the first sign of HIV?

The first sign of HIV is usually flu-like symptoms, which can include rash, fever, chills, fatigue, and sore throat.

Where does the initial HIV rash appear?

The location of the HIV rash varies, but it usually appears on the trunk and face. The rash can also occur on the arms, legs, feet, and hands.

How long does an HIV rash last?

An HIV rash typically lasts one to two weeks. Other symptoms of HIV, like swollen lymph nodes, can last longer.

What are the symptoms of HIV in women?

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

14 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. Naif HM. Pathogenesis of HIV infection. Infect Dis Rep. 2013;5(Suppl 1):e6. doi:10.4081/idr.2013.s1.e6
2. Mohseni S, Shojaiefard A, Khorgami Z, Alinejad S, Ghorbani A, Ghafouri A. Peripheral lymphadenopathy: approach and diagnostic tools.Iran J Med Sci. 2014;39(2 Suppl):158-70.
3. 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
4. Yerly S, Hirschel B. Diagnosing acute HIV infection. Expert Rev Anti-infective Ther. 2012;10(1):31-41. doi:10.1586/eri.11.154
5. 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
6. Anwar KP, Malik A, Subhan KH. Profile of candidiasis in HIV infected patients.Iran J Microbiol. 2012;4(4):204-9.
7. Aziz N, Detel R, Martinez-Mara O, et al. Acute HIV-1 seroconversion with an unusual plasma biomarker profile. Clin Vaccine Immunol. 2013;20(11):1774–1777. doi:10.1128/CVI.00366-13
8. Justiz Vaillant AA, Naik R. HIV-1 associated opportunistic infections. In: StatPearls [Internet]. Updated July 2, 2021.
9. Bryce C. Persistent night sweats: diagnostic evaluation. Am Fam Physician. 2020;102(7):427-433.
10. 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
11. 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
12. HIV.gov. Syphilis and HIV: a dangerous duo affecting gay and bisexual men.
13. HIV.org. Symptoms of HIV.
14. 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.

About HIV

Learning the basics about HIV can keep you healthy and prevent HIV transmission. You can also download materials to share or watch videos on basic information about HIV.

What is HIV?

• HIV (human immunodeficiency virus) is a virus that attacks the body’s immune system. If HIV is not treated, it can lead to AIDS (acquired immunodeficiency syndrome).
• There is currently no effective cure. Once people get HIV, they have it for life.
• But with proper medical care, HIV can be controlled. People with HIV who get effective HIV treatment can live long, healthy lives and protect their partners.

Download and Share

Where did HIV come from?

• HIV infection in humans came from a type of chimpanzee in Central Africa. Studies show that HIV may have jumped from chimpanzees to humans as far back as the late 1800s.
• The chimpanzee version of the virus is called simian immunodeficiency virus. It was probably passed to humans when humans hunted these chimpanzees for meat and came in contact with their infected blood.
• Over decades, HIV slowly spread across Africa and later into other parts of the world. The virus has existed in the United States since at least the mid to late 1970s.

To learn more about the history of HIV in the United States and CDC’s response to the epidemic, see CDC’s HIV and AIDS Timeline.

How do I know if I have HIV?

The only way to know if you have HIV is to get tested. Knowing your HIV status helps you make healthy decisions to prevent getting or transmitting HIV.

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Are there symptoms?

• For many, yes. Most people have flu-like symptoms within 2 to 4 weeks after infection. Symptoms may last for a few days or several weeks.
• Having these symptoms alone doesn’t mean you have HIV. Other illnesses can cause similar symptoms.
• Some people have no symptoms at all. The only way to knowif you have HIV is toget tested.

What are the stages of HIV?

When people with HIV don’t get treatment, they typically progress through three stages. But HIV treatment can slow or prevent progression of the disease. With advances in HIV treatment, progression to Stage 3 (AIDS) is less common today than in the early years of HIV.

• People have a large amount of HIV in their blood and are very contagious.
• Many people have flu-like symptoms.
• If you have flu-like symptoms and think you may have been exposed to HIV, get tested.

• This stage is also called asymptomatic HIV infection or clinical latency.
• HIV is still active and continues to reproduce in the body.
• People may not have any symptoms or get sick during this phase but can transmit HIV.
• People who take HIV treatment as prescribed may never move into Stage 3 (AIDS).
• Without HIV treatment, this stage may last a decade or longer, or may progress faster. At the end of this stage, the amount of HIV in the blood (viral load) goes up and the person may move into Stage 3 (AIDS).

• The most severe stage of HIV infection.
• People with AIDS can have a high viral load and may easily transmit HIV to others.
• People with AIDS have badly damaged immune systems. They can get an increasing number of opportunistic infections or other serious illnesses.
• Without HIV treatment, people with AIDS typically survive about three years.

Ways HIV Can Be Transmitted

Most people get HIV through anal or vaginal sex, or sharing needles, syringes, or other drug injection equipment (for example, cookers). But there are powerful tools to help prevent HIV transmission.

Can I get HIV from anal sex?

You can get HIV if you have anal sex with someone who has HIV without using protection (like condoms or medicine to treat or prevent HIV).

• Anal sex is the riskiest type of sex for getting or transmitting HIV.
• Being the receptive partner (bottom) is riskier than being the insertive partner (top).
• The bottom’s risk is higher because the rectum’s lining is thin and may allow HIV to enter the body during anal sex.
• The top is also at risk. HIV can enter the body through the opening at the tip of the penis (urethra); the foreskin if the penis isn’t circumcised; or small cuts, scratches, or open sores anywhere on the penis.

Can I get HIV from vaginal sex?

You can get HIV if you have vaginal sex with someone who has HIV without using protection (like condoms or medicine to treat or prevent HIV).

• Vaginal sex is less risky for getting HIV than receptive anal sex.
• Either partner can get HIV during vaginal sex.
• HIV can enter a person’s body during vaginal sex through the delicate tissue that lines the vagina and cervix.
• Vaginal fluid and blood can carry HIV, which can pass through the opening at the tip of the penis (urethra); the foreskin if the penis isn’t circumcised; or small cuts, scratches, or open sores anywhere on the penis.

Can HIV be transmitted from a mother to her baby?

HIV can be transmitted from a mother to her baby during pregnancy, birth, or breastfeeding. However, it is less common because of advances in HIV prevention and treatment.

• This is called perinatal transmission or mother-to-child transmission.
• Mother-to-child transmission is the most common way that children get HIV.
• Recommendations to test all pregnant women for HIV and start HIV treatment immediately have lowered the number of babies who are born with HIV.
• If a woman with HIV takes HIV medicine as prescribed throughout pregnancy and childbirth, and gives HIV medicine to her baby for 4 to 6 weeks after birth, the risk of transmission can be less than 1%.

Can I get HIV from sharing needles, syringes, or other drug injection equipment?

You are at high risk for getting HIV if you share needles, syringes, or other drug injection equipment (for example, cookers) with someone who has HIV. Never share needles or other equipment to inject drugs, hormones, steroids, or silicone.

• Used needles, syringes, and other injection equipment may have someone else’s blood on them, and blood can carry HIV.
• People who inject drugs are also at risk for getting HIV (and other sexually transmitted diseases) if they engage in risky sexual behaviors like having sex without protection (such as condoms or medicine to prevent or treat HIV).
• Sharing needles, syringes, or other injection equipment increases your risk for getting hepatitis B and hepatitis C, and other infections.

What are some rare ways that HIV has been transmitted?

There is little to no risk of getting HIV from the activities below. For transmission to occur, something very unusual would have to happen.

Oral Sex

• Oral sex involves putting the mouth on the penis (fellatio), vagina or vulva (cunnilingus), or anus (rimming).
• Factors that may affect the risk of getting HIV include:
  • Ejaculation in the mouth with oral ulcers, bleeding gums, or genital sores.
  • The presence of other sexually transmitted diseases (STDs).

  Workplace

  • The most likely cause is injury with a contaminated needle or another sharp object.
  • Careful practice of standard precautions protects patients and health care personnel from possible occupational HIV transmission.

  Medical Care

  • The US blood supply and donated organs and tissues are thoroughly tested. It is very unlikely that you would get HIV from blood transfusions, blood products, or organ and tissue transplants.
  • You cannot get HIV from donating blood. Blood collection procedures are highly regulated and safe.

  Food Contamination

  • The only known cases are among infants. Contamination occurs when blood from a caregiver’s mouth mixes with pre-chewed food and an infant eats it.
  • You can’t get HIV from consuming food handled by someone with HIV.

  Biting and Spitting

  • The small number of documented cases have involved severe trauma with extensive tissue damage and the presence of blood. This rare transmission can occur through contact between broken skin, wounds, or mucous membranes and blood or body fluids from a person who has HIV.
  • There is no risk of transmission through unbroken skin.
  • There are no documented cases of HIV being transmitted through spitting as HIV is not transmitted through saliva.

  Deep, Open-Mouth Kissing

  • Very rarely, transmission has occurred if both partners have sores or bleeding gums.
  • You can’t transmit HIV through closed-mouth or “social” kissing with someone who has HIV.
  • You can’t transmit HIV through saliva.

  Touching

  • Touching involves putting your hands, other body parts, or sex toys on your partner’s vagina, penis, or anus.
  • The only possible risk would be if body fluids from a person with HIV touch the mucous membranes or damaged tissue of someone without HIV. Mucous membranes are found inside the rectum, vagina, opening of the penis, and mouth. Damaged tissue could include cuts, sores, or open wounds.
  • You can get or transmit some other STDs (like human papillomavirus or HPV, genital herpes, and syphilis) through skin-to-skin contact.
  • If you touch someone’s anus and get feces on your hands or fingers, you can also get or transmit hepatitis A and hepatitis B. Infection with parasites like Giardia and bacteria like Shigella, Salmonella,Campylobacter, and E. coli can also occur.

  Tattoos and Body Piercings

  • There are no known cases in the United States of anyone getting HIV this way.
  • It is possible to get HIV from tattooing or body piercing if the equipment or ink has someone else’s blood in it. This is more likely to happen when the person doing the procedure is unlicensed because they may use unsterilized needles or ink.
  • If you get a tattoo or a body piercing, be sure that the person doing the procedure is properly licensed and uses only new or sterilized equipment.