HIV symptoms in cisgender women and others assigned female at birth (AFAB) can range from common flu-like symptoms to skin changes, mood fluctuations, menstrual irregularities, and recurrent vaginal infections.
Early symptoms of HIV may be mild and easily dismissed. But even without noticeable symptoms, an HIV-positive person can still pass the virus on to others.
That’s one of the many reasons why it’s important for people to know their HIV status.
But not all HIV symptoms are the same for everyone. So how do symptoms differ for people with female anatomy?
Here are the common symptoms that can affect people who have a vulva and vagina.
Stage 1: Acute infection
The body responds to the virus, typically resulting in flu-like symptoms.
In some cases, symptoms are so mild that you may not even notice them. But others may need to be seen by a doctor or other healthcare professional.
Here are some of the symptoms that can be common during the acute stage.
Swollen lymph nodes, or glands, are often one of the first signs of HIV and can last for several months.
Lymph nodes are located throughout the body, including the:
- back of the head
Forming part of the immune system, they fend off infections by storing immune cells and filtering pathogens.
A sore throat is quite a common symptom during the earliest stage of a HIV infection.
It may last a few days, weeks, or even months in rarer cases.
They may appear as cream-colored plaques on the tongue, palate, or lips that often wipe away to leave a red surface underneath.
Other people may develop red ulcers inside the cheeks and lips that can be painful.
Rash is a common symptom and many different types can show up on the skin. They may be a symptom of HIV itself or the result of a concurrent infection or condition.
Some people may experience night sweats within the first month of contracting HIV. They occur when the body attempts to fight the infection during sleep.
One of the most troublesome symptoms for many with HIV, muscles can begin to ache within the first few weeks of an infection. This is often the result of a flu-like episode. (More on this below.)
Other flu-like symptoms
Some people may have other symptoms that resemble the flu, including:
These often go away within a few weeks.
Stage 2: Chronic infection
Also known as the asymptomatic stage, chronic HIV infection is the point where the virus remains at low levels inside the body.
Some people have no symptoms at all during this period —despite the virus still replicating —and this can last for several years.
Others may have more severe symptoms than they experienced during the acute stage. These can range from coughing and fatigue to weight loss and diarrhea. A high fever is also possible.
Stage 3: Acquired immunodeficiency syndrome (AIDS)
This is the most severe HIV stage, where the body’s immune system has been severely weakened.
It becomes more difficult to ward off certain infections, known as opportunistic infections, or diseases.
Infections and diseases
Some of these include:
In general, people with uncontrolled HIV are also more prone to infections of the following areas:
If HIV is uncontrolled, the risk of certain cancers increases, too, including:
More severe premenstrual symptoms have also been noted.
Increased outbreaks of other sexually transmitted infections (STIs)
For people who already have another STI, HIV can lead to worsening symptoms.
The infection can also cause more frequent and intense outbreaks of genital herpes that can be more difficult to treat.
Pelvic inflammatory disease (PID)
- pain during penetrative sex and when urinating
- irregular bleeding
- increased vaginal discharge
In HIV-positive people, it can be harder to treat. Symptoms may also last longer than usual or return more often.
If HIV progresses to AIDS, other symptoms include:
- nausea and vomiting
- weight loss
- severe headache
- joint pain
- muscle aches
- shortness of breath
- chronic cough
- trouble swallowing
- severe night sweats and chills
In the later stages, people may experience:
- short-term memory loss
- mental confusion
The human immunodeficiency virus causes HIV infections, attacking the immune system and weakening the body’s defense against infections and diseases.
As it’s transmitted via contact with bodily fluids, most people are infected through unprotected vaginal or anal sex with someone who’s HIV-positive. (The risk of contracting HIV through oral sex tends to be much lower.)
But coming into contact with infected blood —such as by sharing needles — can also transmit HIV from one person to another.
It’s possible for a birthing parent to transmit HIV to their baby, too. This can occur during pregnancy, childbirth, or nursing.
Key ways to reduce the risk of HIV include the following:
- not sharing needles when using injected drugs
- using a condom properly when having sex alongside water- or silicone-based lubricant to help prevent it slipping or breaking
- taking pre-exposure prophylaxis (PrEP) if you’re at a higher risk of contracting HIV
- not douching — it can alter the natural balance of bacteria and yeast in the vagina, make an existing infection worse, or increase the risk of contracting HIV and other STIs
- getting tested and treated for HIV and other STIs —having an STI can mean a greater risk of contracting HIV
AFAB people without HIV who have HIV-positive partners aren’t at risk of contracting the virus if their partner uses HIV medications daily and achieves viral suppression. However, ongoing use of barrier methods, like condoms, is recommended.
If the above symptoms are present, and there’s concern about the possibility of HIV, a good first step is to get tested.
Testing can be performed confidentially in a medical professional’s office or anonymously at home or at a testing site.
Local public health departments, as well as resources like HIV.gov, offer information on finding testing sites.
If HIV test results are negative but symptoms are still present, consider following up with a healthcare professional. The likes of a rash may be a sign of a serious medical condition, even in people without HIV.
If the HIV test comes back positive, a healthcare professional can assist in creating a treatment plan.
With treatment via antiretroviral medications, the condition can be managed. Recent advancements have significantly improved the life expectancy of people with HIV.
Lauren Sharkey is a U.K.-based journalist and author specializing in women’s issues. When she isn’t trying to discover a way to banish migraines, she can be found uncovering the answers to your lurking health questions. She has also written a book profiling young female activists across the globe and is currently building a community of such resisters. Catch her on Twitter.