Symptoms Of Hiv In Women

Without HIV treatment, people can stay in this stage for 10 or 15 years, but some move through this stage faster.

Signs and Symptoms of HIV in Women

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 October 07, 2022

Anju Goel, MD, MPH, is a board-certified physician who specializes in public health, communicable disease, diabetes, and health policy.

Table of Contents
Table of Contents

Although the signs and symptoms of HIV are largely the same whether you are assigned female or male, there are several specific to women that can occur during early-stage or later-stage infection.

HIV symptoms in women include:

• Frequent yeast infections
• Vaginal burning or soreness
• Irregular periods
• Pelvic pain
• Pain during sex
• Pain when urinating (peeing)
• Bleeding or spotting between periods
• Abnormally heavy vaginal bleeding
• Watery, bloody vaginal discharge, sometimes with a foul odor

In 2018, of the 1.2 million Americans living with HIV, an estimated 37,832 were women. Of these, 1 in 9 are thought to be unaware of their HIV status, according to data from the Centers for Disease Control and Prevention (CDC).

Verywell / Michela Buttignol

Acute HIV Infection

Acute HIV infection, also known as acute seroconversion, is the first of three stages of the disease immediately following exposure to the virus. During acute seroconversion, the immune system will produce defensive antibodies to help fight the virus and bring the infection under control.

From start to finish, acute seroconversion generally lasts for seven to 14 days, during which some people may experience symptoms (referred to as acute retroviral syndrome, or ARS). Symptoms are typically described as being flu-like with mild fever and body ache. Swollen lymph nodes and rash may also accompany.

As many as 43% of people will not experience any signs of acute HIV infection, according to a 2016 study in Emerging Infectious Diseases.  

Disparities in Infection Rates

When acute symptoms develop, they are generally the same in women as they are in men. Where they do vary is the rate of seroconversion.

Heterosexual women are twice as likely to get infected per sexual act compared to heterosexual men (due in part to the increased size and porosity of vaginal tissues compared to those of the penis).

These and other factors confer higher rates of new infections among women compared to men—and also translates to faster disease progression.

According to a 2014 review in the Journal of Infectious Diseases, women with HIV have a 1.6-fold greater risk of progressing to AIDS (the most advanced stage of the disease) than men.

HIV and STD Co-Infection

Other symptoms may develop during acute seroconversion if there an accompanying sexually transmitted disease (STD). Studies suggest that 1 in 7 people with HIV are co-infected with another STD at the time of their diagnosis. Other studies suggest the HIV/STD co-infection rate may be even higher.

Among women with HIV, the most common accompanying STDs are chlamydia, gonorrhea, trichomoniasis (“trich”), and syphilis. Having these infections—or even non-sexually transmitted ones like bacterial vaginosis (BV)—can increase a woman’s risk of getting HIV by two- to three-fold.

These infections undermine the barrier function of the vaginal mucosa and increase the concentration of immune cells at the site of the infection. Among them are CD4 T-cells, the very cells that HIV preferentially targets.

In the case of co-infection, HIV may be identified by the signs and symptoms of the STD rather than those of HIV itself.

It is for this reason that the CDC recommends HIV testing for anyone who seeks the diagnosis and treatment of an STD.

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Chronic HIV Infection

By the end of the acute stage of infection, the immune system brings HIV under control and the virus will establish a set point during which viral activity (as measured by the viral load) will remain stable for months and years.

This chronic stage of infection, referred to as clinical latency, is one in which the infection may progress silently with few notable symptoms. Even so, the virus will continue to infect and deplete CD4 T-cells that the body relies on to fight disease.

Over time, the loss of CD4 T-cells will lead to immunosuppression and an increased risk of opportunistic infections (OIs). They are considered “opportunistic” because an intact immune system would control them.

As the number of CD4 T-cells progressively drops (as measured by the CD4 count), the risk, severity, and range of OIs will increase.

A CD4 count between 500 to 1,200 cells per cubic millimeter (cells/mm3) is considered normal. Any value between 250 and 500 cells/mm3 is a threshold for defining immunosuppression.

Signs and Complications in Women

The symptoms of chronic HIV infection are related to the development of OIs. With that said, secondary conditions affecting a woman’s fertility and menstrual cycle can develop as a result of prolonged immune suppression and chronic inflammation.

The type of OIs commonly seen at CD4 counts between 250 and 500 are more or less the same in females and males. These include herpes simplex, herpes zoster (shingles), bacterial pneumonia, bacterial and fungal skin infections, tuberculosis, and HIV-associated meningitis.

The differences, in any, mainly involve a woman’s reproductive tract. The symptoms may include:

• Recurrent yeast infections: The condition, called vaginal candidiasis, is the result of the overgrowth of a common type of fungus called Candida. The frequency and severity of yeast infection increase with declines in the CD4 count. Vaginal candidiasis is the counterpart to oral thrush experienced by both men and women.
• Vaginal ulcers: Herpes simplex virus type 2 (HSV-2) is associated with genital herpes. In people with HIV, the risk of herpes outbreaks increase at CD4 counts under 500. Vaginal herpes is often the first manifestation of HIV in women (between 52 and 72% of people with HIV are thought to be coinfected with HSV-2).
• Abnormal periods: Women with HIV experience more menstrual problems, including amenorrhea (absence of menstruation) and oligomenorrhea (infrequent menstruation), than HIV-negative women. The risk increases with declines in the CD4 count. A low body mass index (common in women with advanced HIV) and untreated HIV infection are considered key risk factors.
• Chronic pelvic pain: In the same way that STDs can facilitate HIV transmission, the persistent inflammation spurred with HIV can increase a woman’s vulnerability to bacterial STDs like chlamydia and gonorrhea. This accounts for higher rates of pelvic inflammatory disease (PID) among women with HIV. Chronic pelvic pain, irregular periods, and pain with sex are common features of PID.
• Impaired fertility: PID can lead to serious complications in some women, including infertility and ectopic pregnancy. Because HIV suppresses the immune response, PID can persist even when treatment is prescribed. As such, women with HIV are more likely to experience complications of PID than women without, including a tubo-ovarian abscess (TOA).
• Premature menopause: Premature menopause, defined as the onset of menopause before age 40, can occur in women with HIV who smoke, have a low CD4 count, and have low physical activity. Without these factors, women with HIV tend to experience menopause around the age of 50.
• Bone problems: Back pain, stooped posture, a loss of height, and fragile bones are common signs of osteoporosis. Osteoporosis can affect anyone but is most common in postmenopausal women. Among women with HIV, the risk of osteoporosis is four times greater than that of women without. In addition to HIV infection, hepatitis C co-infection and certain HIV drugs are linked to increased bone mineral loss.

In addition to symptoms, women with HIV will often experience changes that are only recognized during a pelvic exam. This may include an abnormal PAP smear or signs of cervical dysplasia (a precancerous condition affecting the cervix).  

AIDS

The third stage of HIV infection is acquired immune deficiency syndrome (AIDS), characterized by symptomatic disease. This is the phase where the immune defenses have been all but wiped out, leaving you in an immunocompromised state.

Without the means to defend yourself from common and uncommon diseases, AIDS runs a high risk of severe and potentially life-threatening illness. These include infections and certain types of cancers as well.

According to the CDC, a person is said to have progressed to AIDS when:

• The CD4 count is under 200 cells/mm3.
• A person gets one of 28 AIDS-defining conditions irrespective of the CD4 count

AIDS-defining conditions include disease are rarely seen among people who have a healthy immune system. They also involve common OIs that have disseminated (spread) from their typical site of infection to other parts of the body.

According to the CDC, the median time of progression from initial HIV infection to AIDS is 11 years if the condition is not treated.

Symptoms of AIDS in Women

The symptoms of AIDS vary little between women and men. There are some variations, including evidence that women with HIV experience greater cognitive decline and may be more likely to experience signs of HIV encephalopathy (a.k.a. AIDS dementia complex) than men.

The one AIDS-defining condition exclusive to women is invasive cervical cancer (ICC). This is the advanced stage of cervical cancer in which tumor cells have spread to tissues deeper within the cervix or to other parts of the body. Though ICC can affect both HIV-positive and HIV-negative women, the incidence among women with HIV is up to seven times greater.

As with other HIV-associated conditions, the risk of ICC increases with declines in the CD4 count. Women with CD4 counts under 200 are six times more likely to get ICC than those whose CD4 counts over 500.  

Arguably more concerning is the fact that the incidence of ICC among women with HIV has remained largely unchanged since the 1990s. This is unlike other AIDS-defining conditions that are rarely seen today due to the advent of combination antiretroviral therapy.  

Though the reasons for this remain unclear, some studies have suggested that women with HIV are more likely to be infected by less prevalent high-risk strains of HPV that current vaccines cannot protect against.  

Non-HIV-Related Conditions

In addition to HIV-related conditions, there are a number of non-HIV-related illnesses commonly seen in people with long-term infection. These include cancers and aging-related diseases that develop an average of 10 to 15 years earlier in people with HIV than those without.

Under the burden of chronic inflammation, the body tissues can undergo changes that literally age them, leading to a phenomenon knows as premature senescence. Particularly if left untreated, HIV can increase the risk of non-HIV-related cancers and cardiovascular diseases, including heart attacks and strokes.

In some cases, women are disproportionately affected. Studies suggest, for instance, that women with HIV have a higher risk of heart disease than men due to the activation of white blood cells called monocytes that promote cardiovascular inflammation.

Similarly, women with HIV who engage in anal sex are at increased risk of anal cancer (due to HPV co-infection). While anal cancer is relatively rare in the United State, women with HIV are 30 times more likely to be affected than women in the general population.

Non-AIDS-defining cancers are the leading cause of death in people with HIV in the developed world, according to research published in the Journal of the International AIDS Society.

A Word From Verywell

Although certain symptoms may suggest you have HIV, the absence of symptoms should not be considered an all-clear flag. Today, an estimated 1 in 7 Americans living with HIV remain undiagnosed, either because they have no idea they have been infected or are ignoring their suspicions.

If diagnosed and treated early, people with HIV can live long, healthy lives and reduce the risk of HIV-related and serious non-HIV-related illnesses by up to 72%.

The U.S. Preventive Services Task Force currently recommends at least one HIV test for all Americans 15 to 65 as part of a routine medical exam. If you have risk factors for HIV and have not been tested, there may be no better time to do so than now.

29 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.

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By James Myhre & Dennis Sifris, MD
Dennis Sifris, MD, is an HIV specialist and Medical Director of LifeSense Disease Management. James Myhre is an American journalist and HIV educator.

HIV Symptoms in Women

The symptoms of HIV are mostly the same for men and women. But there can be some differences between the genders.

Women’s HIV Symptoms

There are a few signs that happen only in women, often in the later stages of infection:

Changes in your period. You may have lighter or heavier bleeding, skip periods, or have severe PMS. Stress or other STDs, which are common with HIV, can cause these issues. But they may also happen because of the virus’s effects on your immune system, which may change your hormones.

Lower belly pain. This is one of the signs of an infection of your uterus, ovaries, and fallopian tubes, called pelvic inflammatory disease (PID). PID can also cause:

• Unusual vaginal discharge
• Fever
• Irregular periods
• Pain during sex
• Pain in your upper belly

Vaginal yeast infections. Many women with HIV get these often, sometimes several times a year. When you get a yeast infection, you can have:

• Thick white discharge from your vagina
• Pain during sex
• Pain when you pee
• Vaginal burning or soreness

Cernical Cancer. While not a symptom of HIV, cervical cancer can be an AIDS-defining condition. Women with HIV should be screened for cervical cancer annually and treated as needed.

Early HIV Symptoms

For both men and women, about 2 to 4 weeks after you’re infected, you may feel like you have the flu. It’s a sign that your body is responding to the virus. This may last a few weeks.

Symptoms of a new HIV infection include:

Men and women with HIV can get a yeast infection of the mouth, called thrush or oral candidiasis. It causes swelling and a thick white coating over your mouth, tongue, and throat.

Some people have no symptoms of early HIV infection. But you should get tested if you think you might have been exposed to HIV.

See your doctor or go to the emergency room right away if you think you could have been exposed to the virus in the past couple of days. Medications called post-exposure prophylaxis (PEP) can keep you from getting HIV. But they work only if you take them within 72 hours of getting the virus. Your doctor can give you a prescription for PEP, and you’ll take them once or twice a day for 28 days.

Later HIV Stages

After flu-like symptoms in the first few weeks, you’ll go into what doctors call the clinical latency stage, also called asymptomatic HIV infection or chronic HIV infection. You’ll start to feel better while the virus makes copies of itself in your body. Most people don’t have any symptoms during this stage.

Antiretroviral therapy (ART) medicines will keep you healthy and keep you from spreading HIV to others. If you take the drugs as prescribed, you can stay in the latency stage for decades and even have a regular life span.

Be up-front about your condition with potential sex partners. They should get tested for HIV. Use a condom correctly every time you have sex to protect against HIV as well as other sexually transmitted diseases.

Show Sources

CDC: “About HIV/AIDS;” “Diseases Characterized by Genital, Anal, or Perianal Ulcers;” and “HIV Basics: Prevention.”

Office of Women’s Health, U.S. Department of Health and Human Services: “Genital Ulcers;” “Menstrual Problems;” “Pelvic Inflammatory Disease;” and “Vaginal Yeast Infections.”

Aids.gov: “How Can I Tell If I Have HIV?” and “When One Partner is HIV+.”

National Institutes of Health: “HIV and Women.”

Symptoms of HIV

The only way to know for sure if you have HIV is to get tested. You can’t rely on symptoms to tell whether you have HIV.

Knowing your HIV status gives you powerful information so you can take steps to keep yourself and your partner(s) healthy:

• If you test positive, you can take medicine to treat HIV. People with HIV who take HIV medicine (called antiretroviral therapy or ART) as prescribed and get and keep an undetectable viral load can live long and healthy lives and will not transmit HIV to their HIV-negative partners through sex. An undetectable viral load is a level of HIV in the blood so low that it can’t be detected in a standard lab test.
• If you test negative, you have more HIV prevention tools available today than ever before, like pre-exposure prophylaxis (PrEP), medicine people at risk for HIV take to prevent getting HIV from sex or injection drug use, and post-exposure prophylaxis (PEP), HIV medicine taken within 72 hours after a possible exposure to prevent the virus from taking hold.
• If you are pregnant, you should be tested for HIV so that you can begin treatment if you’re HIV-positive. If you have HIV and take HIV medicine as prescribed throughout your pregnancy and childbirth and give HIV medicine to your baby for 4 to 6 weeks after giving birth, your risk of transmitting HIV to your baby can be less than 1%. HIV medicine will protect your own health as well.

Use the HIV Services Locator to find an HIV testing site near you.

HIV self-testing is also an option. Self-testing allows people to take an HIV test and find out their result in their own home or other private location. You can buy a self-test kit at a pharmacy or online, or your health care provider may be able to order one for you. Some health departments or community-based organizations also provide self-test kits for a reduced cost or for free. Learn more about HIV self-testing and which test might be right for you.

What Are the Symptoms of HIV?

There are several symptoms of HIV. Not everyone will have the same symptoms. It depends on the person and what stage of the disease they are in.

Below are the three stages of HIV and some of the symptoms people may experience.

Stage 1: Acute HIV Infection

Within 2 to 4 weeks after infection with HIV, about two-thirds of people will have a flu-like illness. This is the body’s natural response to HIV infection.

Flu-like symptoms can include:

• Fever
• Chills
• Rash
• Night sweats
• Muscle aches
• Sore throat
• Fatigue
• Swollen lymph nodes
• Mouth ulcers

These symptoms can last anywhere from a few days to several weeks. But some people do not have any symptoms at all during this early stage of HIV.

Don’t assume you have HIV just because you have any of these symptoms—they can be similar to those caused by other illnesses. But if you think you may have been exposed to HIV, get an HIV test.

Here’s what to do:

• Find an HIV testing site near you—You can get an HIV test at your primary care provider’s office, your local health department, a health clinic, or many other places. Use the HIV Services Locator to find an HIV testing site near you.
• Request an HIV test for recent infection—Most HIV tests detect antibodies (proteins your body makes as a reaction to HIV), not HIV itself. But it can take a few weeks after you have HIV for your body to produce these antibodies. There are other types of tests that can detect HIV infection sooner. Tell your doctor or clinic if you think you were recently exposed to HIV and ask if their tests can detect early infection.
• Know your status—After you get tested, be sure to learn your test results. If you’re HIV-positive, see a health care provider as soon as possible so you can start treatment with HIV medicine. And be aware: when you are in the early stage of infection, you are at very high risk of transmitting HIV to others. It is important to take steps to reduce your risk of transmission. If you are HIV-negative, there are prevention tools like pre-exposure prophylaxis (PrEP) that can help you stay negative.

Stage 2: Clinical Latency

In this stage, the virus still multiplies, but at very low levels. People in this stage may not feel sick or have any symptoms. This stage is also called chronic HIV infection.

Without HIV treatment, people can stay in this stage for 10 or 15 years, but some move through this stage faster.

If you take HIV medicine exactly as prescribed and get and keep an undetectable viral load, you can live and long and healthy life and will not transmit HIV to your HIV-negative partners through sex.

But if your viral load is detectable, you can transmit HIV during this stage, even when you have no symptoms. It’s important to see your health care provider regularly to get your viral load checked.

Stage 3: AIDS

If you have HIV and you are not on HIV treatment, eventually the virus will weaken your body’s immune system and you will progress to AIDS (acquired immunodeficiency syndrome).

This is the late stage of HIV infection.

Symptoms of AIDS can include:

• Rapid weight loss
• Recurring fever or profuse night sweats
• Extreme and unexplained tiredness
• Prolonged swelling of the lymph glands in the armpits, groin, or neck
• Diarrhea that lasts for more than a week
• Sores of the mouth, anus, or genitals
• Pneumonia
• Red, brown, pink, or purplish blotches on or under the skin or inside the mouth, nose, or eyelids
• Memory loss, depression, and other neurologic disorders

Each of these symptoms can also be related to other illnesses. The only way to know for sure if you have HIV is to get tested. If you are HIV-positive, a health care provider will diagnose if your HIV has progressed to stage 3 (AIDS) based on certain medical criteria.

Many of the severe symptoms and illnesses of HIV disease come from the opportunistic infections that occur because your body’s immune system has been damaged. See your health care provider if you are experiencing any of these symptoms.

But be aware: Thanks to effective treatment, most people in the U.S. with HIV do not progress to AIDS. If you have HIV and remain in care, take HIV medicine as prescribed, and get and keep an undetectable viral load, you will stay healthy and will not progress to AIDS.

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