Early treatment prevents often-irreversible damage to the immune system. It also reduces the risk of passing the virus to others, a strategy known as treatment as prevention (TasP).
What Are the Early Signs and Symptoms of HIV in Men?
Symptoms of HIV in cisgender males can vary as much as between two people of different sexes. They may include symptoms of illness such as fever, cough, vomiting, or swollen lymph nodes. These may be mild or severe, depending on the stage of the disease.
If you’re reading this, odds are it’s because you asked Dr. Google “what are the symptoms of HIV in men,” or you’re a male assigned at birth (MAAB) who stumbled on this article and is simply interested in becoming better informed about HIV.
The information about HIV below can be useful for people across the gender spectrum. Read on for a complete breakdown of the most common early signs and symptoms of HIV. Plus, information about HIV testing and prevention.
HIV — short for human immunodeficiency virus — is a virus that affects the immune system — more specifically, white blood cells known as CD4 cells, or T-cells, that are part of the immune system.
Because HIV attacks the immune system itself, the immune system is not able to mount a defensive response against this virus the way it can for other viruses. It also means that a person with (untreated) HIV is more susceptible to other infections, illnesses, and diseases.
HIV can be transmitted from person to person through contact with blood, semen, or vaginal fluids that contain the virus.
“It is primarily spread through sex, sharing needles, blood transfusion, and mother to baby during delivery,” says Jennifer Veltman, MD, chief of infectious diseases at Loma Linda University Health.
HIV vs. AIDS
HIV is not synonymous with AIDS. Acquired immunodeficiency syndrome (AIDS), also known as stage 3 HIV. It’s a late stage of HIV when the immune system cells have been so badly damaged that the body is no longer able to fight off infection.
Thanks to modern medicine, with proper treatment, it’s incredibly uncommon for HIV to progress to AIDS. (More on this below).
Before we do a more in-depth discussion about the symptoms of HIV, it’s important to understand that left untreated HIV can progress through the following three stages, each of which has a group of associated symptoms.
- Stage 1: acute illness
- Stage 2: asymptomatic period
- Stage 3: advanced infection
Below, a complete breakdown of the most common symptoms by stage.
Stage 1: Acute illness
Stage 1 of HIV can be considered the “beginning” stage. It’s the stage a person enters when they first contract the virus, and it lasts until the body has created antibodies against the virus.
Antibodies are basically little bodyguards the immune system creates when exposed to foreign invaders.
Somewhere between 66 and 80 percent of people in stage 1 will experience flu-like symptoms within 2 to 4 weeks of transmission.
According to doctoral-prepared nurse practitioner Emily Rymland, AAHIVS-certified HIV specialist and clinical development manager at Nurx, these flu-like symptoms can include:
- fever
- swollen glands
- fatigue
- body rash
- sore throat
- joint pain
- diarrhea
- headaches
Symptoms can also include:
- ulcers in the mouth
- sores on the genitals
- muscle aches
- nausea
- vomiting
- night sweats
“The reason HIV causes joint and muscle pain is because the infection causes inflammation in the body,” says Rymland.
When someone has symptoms, their symptoms can last a few days to several weeks, she says. But not everyone who has come into contact with the virus will experience symptoms.
“It’s common for someone to experience no symptoms that would lead them to question whether or not they’d been exposed to HIV,” explains Rymland.
That’s why anyone who has these symptoms or thinks they may have contracted HIV should consider scheduling an appointment with a healthcare professional to get tested.
“You want to know your status as soon as possible, as early treatment is best for preventing future illness or symptoms,” she says.
Stage 2: Asymptomatic stage
Also known as the clinical latency stage, this stage of HIV is known for its lack of symptoms.
During this stage, the virus exists — and is multiplying — in the body and is beginning to weaken the immune system. But it isn’t (yet) actively causing symptoms.
A person with HIV at this stage may feel and look totally fine. But they can still easily transmit the virus to others.
Stage 3: AIDS
It may take years, even decades, but when left untreated HIV may attack and destroy enough CD4 cells that the body can no longer fight off infection and disease. In short: It breaks down the immune system.
Once this happens, HIV will progress to stage 3, often referred to as AIDS.
A person at this stage has a severely damaged immune system, making them more susceptible to something called “opportunistic infections.”
Opportunistic infections are conditions that the body would normally be able to fight off but can be harmful to people who have HIV.
People living with HIV may notice that they frequently develop colds, flu, and fungal infections.
The symptoms someone with stage 3 HIV might experience include:
- nausea
- vomiting
- persistent diarrhea
- chronic fatigue
- rapid weight loss
- cough
- shortness of breath
- recurring fever, chills, and night sweats
- rashes, sores, or lesions in the mouth or nose, on the genitals, or under the skin
- prolonged swelling of the lymph nodes in the armpits, groin, or neck
- memory loss, confusion, or neurological disorders
“When someone’s CD4 count drops below 200, that’s when someone becomes susceptible to opportunistic infections like pneumocystis pneumonia,” says Rymland.
This may all sound pretty scary, but remember that HIV can be managed with medication called antiretroviral therapy. (More on this below).
Early Signs and Symptoms of HIV
Dennis Sifris, MD, is an HIV specialist and Medical Director of LifeSense Disease Management. James Myhre is an American journalist and HIV educator.
Updated on August 26, 2022
Isaac O. Opole, MD, PhD, is a board-certified internist and a current teaching professor of medicine at the University of Kansas.
In the early stages of infection, many people will develop little or no signs of illness. This is, perhaps, one of the reasons why 14% of the 1.2 million Americans living with HIV go undiagnosed. They either don’t realize they’ve been infected or will only act when outward signs begin to appear.
However, in some cases, flu-like symptoms will develop within 7 to 14 days of exposure. This condition is commonly referred to as acute retroviral syndrome (also referred to as ARS, acute seroconversion syndrome, or seroconversion illness).
Acute Symptoms
Verywell / Nusha Ashjaee
ARS can often present with the following acute symptoms, ranging from mild to severe:
- Fever
- Fatigue
- Headache
- Pharyngitis (sore throat)
- Myalgia (muscular aches and pain)
- Arthralgia (joint pain)
- Lymphadenopathy (swollen lymph glands)
Occasionally, these symptoms will be accompanied by a rash (commonly referred to as an HIV rash) which manifests with pink-to-red bumps that converge into larger patches, primarily on the upper half of the body. Moreover, 30% of people will experience short-term nausea, diarrhea, or vomiting.
Most of these symptoms are a result of the body’s response to HIV as it rapidly spreads from the site of infection to lymph tissue, triggering an inflammatory response.
ARS can persist for months until the immune system is finally able to take control of the virus. This is followed by the chronic stage of infection in which the virus slowly dismantles the immune defense over months and years.
While HIV will still be replicating at this stage, it generally does so at a slower rate until the viral load finally levels off and establishes a so-called “viral set point.”
Confirming Infection
ARS can be missed even by a doctor because the symptoms are often so flu-like in their presentation. It is, therefore, important to understand how HIV is transmitted; to recognize the acute symptoms of HIV, and to get an HIV test should you suspect you have been infected.
Since an HIV test can often deliver a negative or indeterminate result during the early stages of infection, an HIV viral load test can be used if symptoms are suggestive of ARS.
In such instances, if the person has a negative or indeterminate antibody result but a high viral load (over 100,000 copies/mL), they would be considered HIV-positive. Treatment would ideally begin immediately, while a follow-up test would be performed at a later date to confirm the results.
Newer combination antibody/antigen assays have also proven highly effective in confirming serostatus during ARS, with some of the test displaying extremely high levels of accuracy.
The U.S. Preventive Services Task Force currently recommends one-time testing of all Americans 15 to 65 as part of a routine doctor visit.
Other people at higher risk for infection—including sexually active men who have sex with men (MSM)—should be tested annually. For some MSM, the Centers for Disease Control and Prevention (CDC) recommends screening every 3 to 6 months based off of sexual history.
Benefits of Early Detection
Recognizing the symptoms of ARS is important as it affords a person the opportunity for early detection. This not only helps ensure that HIV is not spread to others, but offers benefits in the way of early treatment.
Studies published in 2013 indicate that the early initiation of antiretroviral therapy correlates to a reduced risk of both HIV-related and AIDS-defining illnesses. By contrast, delaying therapy until a person’s CD4 count drops below 350 cells/mL is associated with not only more adverse clinical events, but a significant—and even profound—reduction in life years.
Early treatment prevents often-irreversible damage to the immune system. It also reduces the risk of passing the virus to others, a strategy known as treatment as prevention (TasP).
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