Signs and Symptoms of HIV

This article is part of Health Divide: HIV, a destination in our Health Divide series.

HIV is typically described in phases during which certain symptoms are more likely to develop. As with the course of the condition itself, the symptoms are not the same for all people. Some symptoms may develop earlier or later than others or not at all.

HIV's acute stage can last for around two to four weeks, after which symptoms will spontaneously resolve as the body brings HIV under control. The presence of HIV in the body is not gone but instead moves into the next phase, known as clinical latency.

Some of the symptoms may be the direct result of HIV exposure, while others, particularly those in the latter stages, are caused when the destruction of the immune system leaves the body vulnerable to opportunistic conditions.

In some of the earlier stages of HIV exposure, a person may be entirely asymptomatic (without symptoms) even though the immune system is progressively damaged. Some of the most serious and potentially life-threatening opportunistic conditions can occur when the immune defenses are fully compromised.

Symptoms of Acute HIV

Verywell / Colleen Tighe

HIV is not equal in the population of people it affects. Because fewer Black people with HIV receive HIV-specific care than those living with HIV in general (63% vs. 66%), fewer can achieve complete viral suppression while on treatment (51% vs. 57%). This leaves Black people at greater risk of developing opportunistic conditions and dying.

HIV Among Black People in the U.S.

Black people with HIV in the United States have an eight-fold greater risk of death compared to White people with HIV (19.8 per 100,000 vs. 2.9 per 100,000). And this, despite the fact that Black people are no less likely to be diagnosed during late-stage HIV exposure than White people.

Stage 1: Primary Exposure (Acute HIV)

Stage 1 is the phase when HIV enters the body, and the immune system launches its frontline defenses. Also known as acute HIV, primary HIV, acute seroconversion, or acute retroviral syndrome, stage 1 is characterized by the body's efforts to bring HIV under control.

In fighting the virus, the immune system will release chemicals that trigger a whole-body inflammatory response. This can lead to flu-like symptoms in 2 of every 3 newly exposed people, usually within two to four weeks.

Symptoms of acute HIV include:

One in 5 people may also develop an "HIV rash" with raised, reddened areas of skin covered with small pimple-like bumps. The rash will often affect the upper body and may be accompanied by ulcers of the mouth and genitals.

The acute stage of HIV can last for around two to four weeks, after which symptoms will spontaneously resolve as the body brings it under control. The presence of HIV is not gone but instead moves into the next phase known as clinical latency.

HIV Among Black MSM and Trans People (Especially Trans Women)

Signs of acute HIV are the same for all people, no matter their race or sex. With that said, Black people and men who have sex with men (MSM) account for the lion's share of new HIV diagnoses. Black trans people, with emphasis on Black trans women and feminine people, also have higher chances of testing positive for HIV than the general population. Studies show stigma, lack of access to health care, and discrimination contribute to the high rate of diagnosis in these populations. Reports have shown 62% of Black trans women in the United States are living with HIV. The Black trans community at large, including Black transmasculine people, test HIV positive at higher rates than the broader population. Roughly 30% of all new cases are among Black MSM who have no less than a 50/50 chance of getting HIV in their lifetime.

Stage 2: Clinical Latency (Chronic HIV)

Stage 2 is when the acute symptoms have largely resolved, and HIV will persist but be far less active. Although lymphadenopathy (swollen lymph nodes) may persist for months following the initial exposure, this stage of HIV progression is largely asymptomatic.

Also known as clinical latency or chronic HIV, stage 2 is characterized by the gradual destruction of immune cells, called CD4 T cells, and the gradual increase in the number of viruses in the body, as measured by the viral load. The Centers for Disease Control and Prevention (CDC) broadly defines the chronic stage of HIV as a CD4 count of between 499 and 200.

Without treatment, the chronic phase can last for around 10 years, during which there may be few notable symptoms. But, as the CD4 count continues to drop, an ever-widening range of opportunistic conditions can develop, both common and uncommon.

During this stage, the symptoms, if any, are generally related to these conditions, which can include:

Low CD4 Count

Verywell / Julie Bang

HIV Progression

The progression of HIV is not the same for all people. For some, the period of clinical latency may only last for two years. Although there are many reasons for this, including a person's genetics, social factors like poverty and the lack of access to health care also play a role.

Studies suggest that low socioeconomic status is associated with poorer immune status in people with HIV as measured by the CD4 count. A low CD4 count at the time of diagnosis is, in turn, associated with a faster HIV progression.

HIV and Poverty in Black and Latinx Communities

According to the CDC, the rate of poverty among people living with HIV in urban Latinx and Black communities is four and 19 times greater, respectively, than their White counterparts. This translates to faster disease progression and poorer survival times in people of color.

Stage 3: Symptomatic HIV (AIDS)

Stage 3 is the phase where the immune system has been compromised and unable to defend itself against an ever-expanding array of serious opportunistic conditions. Also known as AIDS (acquired immune deficiency syndrome), stage 3 is defined by the CDC as having a CD4 count under 200 or the presence of an AIDS-defining condition.

AIDS-defining conditions are those that occur in the setting of advanced HIV and are rarely seen in people with intact immune systems. Some infections, like tuberculosis, can occur at CD4 counts well count over 200, but most occur when the CD4 count drops below 200.

On the flip side, it is possible to have a CD4 under 200 and no AIDS-defining condition. Even so, aggressive steps will be taken to prevent them from occurring. This includes starting antiretroviral therapy if you haven't already done so and, if needed, taking disease-specific prophylactic (preventive) drugs.

Symptoms at this stage are primarily related to the opportunistic conditions, although some, like AIDS dementia, are due to the consequence of long-term untreated HIV. Others are only considered AIDS-defining if they recur, are disseminated (widely dispersed), or are invasive (spread beyond their original site).

There are 27 conditions classified as AIDS-defining by the CDC:

AIDS Diagnoses Among Black People

Due to health inequities and other factors, Black people with HIV are more than 10 times more likely to progress to AIDS than White people and three times more likely than Latinx people.

A Word From Verywell

Knowing the symptoms of HIV can help you seek timely diagnosis and treatment. But, symptoms alone should not be the reason for you to get a test.

If you suspect that you've been exposed to HIV, either now or anytime in the past, see your healthcare provider and ask to be tested. Because there are treatments today that can help you live a long, healthy life, the CDC recommends HIV testing at least once for everyone ages 13 to 64 as part of routine medical care.

By doing so, you not only protect your long-term health but others around you.

Frequently Asked Questions

  • Can HIV symptoms differ by sex?

    Yes. People assigned female at birth may experience repeat vaginal yeast infections, pelvic inflammatory disease, irregular menstrual cycles, higher risks of cervical cancer and osteoporosis, and earlier menopause than those who do not have HIV. People assigned female at birth may also have more severe side effects from HIV medication and drug interactions between birth control and HIV medication.

  • Can you receive a false-positive HIV test result?

    Yes, false-positive HIV test results can occur, but they are very rare. Sometimes, false positives occur if the test is mishandled or mislabeled, specimens are mixed up, or results are misread. Autoimmune disorders or other medical conditions can also affect the test results.

  • How do you acquire HIV?

    HIV is usually transmitted through sexual contact, sharing drug needles, or from birthing parent to baby during pregnancy, childbirth, or nursing.

Was this page helpful?
18 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. National Institutes of Health. The stages of HIV infection.

  2. O'Brien M, Markowitz M. Should we treat acute HIV infection? Curr HIV/AIDS Rep. 2012;9(2):101–110. doi:10.1007/s11904-012-0113-0

  3. Centers for Disease Control and Prevention. HIV and African American people.

  4. Kaiser Family Foundation. Estimated death rates (per 100,000) of adults and adolescents with an HIV diagnosis, by race/ethnicity.

  5. Hall HI, Tang T, Espinoza L. Late HIV diagnosis in metropolitan areas of the United States and Puerto Rico. AIDS Behav. 2016;20(5):967-972. doi:10.1007/s10461-015-1241-5

  6. How can you tell if you have HIV?

  7. Cowen EA, McGowan JP, Fine SM, et al. Diagnosis and management of acute HIV. In: Clinical guidelines program New York State Department of Health AIDS Institute. Baltimore, MD: John Hopkins University.

  8. Centers for Disease Control and Prevention. HIV prevalence.

  9. Hess KL, Hu X, Lansky A, Mermin J, Hall HI. Lifetime risk of a diagnosis of HIV infection in the United States. Ann Epidemiol. 2017;27(4):238-243. doi:10.1016/j.annepidem.2017.02.003

  10. Centers for Disease Control and Prevention. Monitoring selected national HIV prevention and care objectives by using HIV surveillance data United States and 6 dependent areas, 2019.

  11. Department of Health and Human Services. Guidelines for prevention and treatment of opportunistic infections in HIV-infected adults and adolescents.

  12. McMahon J, Wanke C, Terrin N, Skinner, Knox T. Poverty, hunger, education, and residential status impact survival in HIV. AIDS Behav. 2011;15(7):1503–1511. doi:10.1007/s10461-010-9759-z

  13. Centers for Disease Control and Prevention. Economically disadvantaged.

  14. Kaiser Family Foundation. AIDS diagnoses, adults and adolescents, by race/ethnicity.

  15. Centers for Disease Control and Prevention. HIV testing.

  16. MedlinePlus. HIV/AIDS in women.

  17. Centers for Disease Control and Prevention. False-positive HIV test results.

  18. Centers for Disease Control and Prevention. Ways HIV can be transmitted.

Additional Reading