Where does the initial HIV rash appear?

It can vary from person to person, but it mostly appears on the trunk and face. It sometimes may 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, like swollen lymph nodes, can last longer.

What are the symptoms of HIV in women?

Women and men generally have the same symptoms, 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 .

7 Top Signs That You May Have HIV

There are no signs or symptoms that can diagnose HIV; only an HIV test can. With that said, there are certain clues that suggest a person may have HIV. The signs can vary based on whether a person is in the acute (new) or chronic (persistent) stage of infection.

Acute symptoms occur when the immune system mounts a defense against the virus as it first enters the body. These early symptoms are caused by the body's response to the virus and are referred to as acute retroviral syndrome (ARS).

Chronic symptoms occur when the virus breaks down the body's immune defenses, leaving it open to infection. During the chronic stage, many of these symptoms are non-specific, meaning that they could be caused by any number of things.

This article details seven signs and symptoms that can easily be missed if you have or have been recently diagnosed with HIV.

An Unexplained Rash

HIV rash — U.S. National Library of Medicine / National Institutes of Health

A rash is often the first sign of HIV, although it only appears in 2 of every 5 newly infected people. The rash is distinct with large areas of flat, reddened skin peppered with tiny bumps. The rash can be itchy or painful. Flu-like symptoms are also common.

The rash usually starts two to six weeks after exposure to the virus and will clear within one to two weeks. The widespread rash mainly affects the trunk and face, but can sometimes occur 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 may need to consider HIV as a possible cause.

Swollen Lymph Nodes

swollen cervical lymph node (lymphadenopathy) — National Institutes of Health

Swollen lymph nodes (lymphadenopathy) can occur in the early stages of HIV as the body tries to kill the virus. it most often affects the lymph nodes of the armpits, neck, groin, or behind the ear. The swelling can sometimes be painful and even unsightly.

Even as the other signs of the acute infection clear, swollen lymph nodes can persist in some people for many weeks or months.

Lymphadenopathy is also common with opportunistic infections like tuberculosis as well as HIV-associated cancers.

Oral Thrush

One of the early opportunistic infections in people living with HIV is oral thrush. It is considered "opportunistic" because it seizes the opportunity to infect when the immune system is weak.

Oral thrush, also known as oral candidiasis, is caused by a fungus that can invade the inside of the mouth and throat. It can affect people who are relatively healthy but is still a sign that the immune system is breaking down.

If the breakdown of the immune system is severe, the fungus can spread into the windpipe, lungs, and even the bloodstream.

Oral thrush does not automatically mean HIV, but it may warrant an HIV test if you are at risk of infection.

Recap

Oral thrush is one of the early signs that your immune system is breaking down as a result of HIV.

Night Sweats

Creative Commons https://www.flickr.com/photos/breatheindigital/4668093768 — Ryan Hyde / Flickr Creative Commons

Night sweats, also known as sleep hyperhidrosis, can occur either during the acute stage as the body fights the virus or during the chronic phase as a result of an opportunistic infection.

As opposed to just being sweaty, night sweats are when your clothing and bedding are drenched in sweat, often soaking through and causing shivers. Sweating of this level is never considered normal.

Night sweats can occur for other reasons, some of which are not serious (such as menopause) and others that may be (like cancer). If you have drenching night sweats, don't hesitate to have it checked it out.

Sudden, Unexplained Weight Loss

man standing on weight scale — National Human Genome Research Institute

Weight loss is common in people living with HIV during the advanced stages of the disease. This is not about the loss of just a few pounds. This is the sudden, unexplained loss of 10% or more, in which both fat mass and lean muscle are lost.

Also known as HIV wasting syndrome, the condition is seen less often today due to the use of antiretroviral drugs that 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 increases the speed at which energy is burnt and reduces testosterone levels needed to build lean muscle.

Other common causes of wasting include malnutrition, chronic diarrhea, tuberculosis, and cancer, all of which require urgent diagnosis and treatment.

Recap

HIV wasting is the loss of 10% or more of body weight. It is linked to untreated, advanced HIV infection during which both body fat and lean muscle mass are lost.

A Sexually Transmitted Infection (STI)

Used under a Creative Commons license at https://www.pexels.com/photo/love-people-kissing-romance-18397/. — Katie Salerno/Flickr Creative Commons

If you have a sexually transmitted infection (STI), there is a chance you may have HIV as well. The odds may be greater than you think.

Some STIs like syphilis and herpes cause open sores that make it easier for HIV to enter the body. Others like gonorrhea and chlamydia cause inflammation in the genitals that attracts the very immune cells (called 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 do the same. Because of this, you should be tested for HIV if you test positive for any STI.

No Symptoms

young man shrugging — Jaime Grill / Getty Images

In truth, the most common sign of HIV is no symptom at all. This is particularly true during the acute stage, in which as many as two out of three people will be wholly unaware of their condition.

During the chronic stage, the disease may also be largely "silent," and any symptoms you have may be non-specific or mistaken for other health concerns.

Never assume that not having symptoms is the same thing as not having HIV. The lack of symptoms doesn't mean that your condition is "mild" or that your immune system isn't being harmed. It is.

If you are at risk of HIV, it is in your interest to get it checked out by getting an HIV test.

HIV Testing Recommendation

The U.S. Preventive Services Task Force currently recommends that all Americans ages 15 to 65 be tested for HIV as part of a routine doctor's visit.

HIV Healthcare Provider Discussion Guide

Get our printable guide for your next healthcare provider's appointment to help you ask the right questions.

Download PDF

Summary

While only an HIV test can diagnose HIV, there are certain symptoms that may suggest you've acquired the virus. These include:

An unexplained rash with flu-like symptoms
Swollen lymph nodes
Oral thrush
Drenching night sweats
Unexplained weight loss of 1O% or more
Having an STI

You may also have no symptoms. However, the lack of symptoms does not mean that the disease is "mild" or your immune system is not being harmed. Untreated HIV can lead to opportunistic infections that can be serious.

Frequently Asked Questions

Where does the initial HIV rash appear?

It can vary from person to person, but it mostly appears on the trunk and face. It sometimes may 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, like swollen lymph nodes, can last longer.
What are the symptoms of HIV in women?

Women and men generally have the same symptoms, 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.

Learn More: Signs and Symptoms of HIV in Women

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