Symptoms of HIV in cisgender men and others assigned male at birth can vary but may include fever, cough, vomiting, or swollen lymph nodes. These may be mild or severe, depending on the stage of the disease.
The following information about HIV can be useful for men, as well as all sexes and genders. Read on for a complete breakdown of the most common early signs and symptoms of HIV. Plus, information about HIV testing and prevention, and how to become better informed about HIV.
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,” said Jennifer Veltman, MD, chief of infectious diseases at Loma Linda University Health.
HIV vs. AIDSHIV is not synonymous with AIDS, which is now known as stage 3 HIV. It’s a late stage of HIV when the immune system cells have become severely damaged and no longer able to fight off infection.
With medical advances and proper treatment, it’s
less common for HIV to progress to stage 3 HIV.
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
The following sections offer a complete breakdown of the most common symptoms by stage.
Stage 1: Acute illness
Stage 1 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 that the immune system creates when exposed to foreign invaders.
Many people with stage 1 HIV will experience flu-like symptoms within
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,” explained Rymland.
When someone has symptoms, their symptoms can last a few days to several weeks, she said. 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,” continued 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 said.
Stage 2: Asymptomatic stage
Also known as the clinical latency stage or chronic HIV infection, 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, or Stage 3 HIV
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, previously referred to as AIDS.
At this stage, a person’s immune system is severely damaged, making them more susceptible to “opportunistic infections.”
Opportunistic infections are conditions that the body would usually 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
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,” said Rymland.
This may all sound pretty scary, but remember that HIV can be managed with medication called antiretroviral therapy.
No, not really. Symptoms of HIV are generally the same in people of all sexes and genders.
One HIV symptom that is unique to people with penises that can occur is an ulcer on the penis. They’re often caused by a concomitant sexually transmitted infection (STI), like syphilis, herpes simplex virus, or chancroid.
Hypogonadism, when the body
People with any type of genitalia can develop hypogonadism, but it’s easier to observe the effects in people with a penis, such as:
- erectile dysfunction
- lower sperm count
- loss of body hair
Due to the virus’s early nomenclature as GRID, or gay-related immune deficiency, it’s wrongly assumed to affect only gay men.
Rymland says this pervasive stigma prevents nongay men, as well as other-gendered individuals, from protecting themselves against HIV transmission or even getting tested for STIs.
“People of all sexual orientations need to be educated about their risk and informed on how to protect themselves,” she said. “And that includes being educated about PrEP, a safe and effective medication for preventing HIV that’s not well known outside of the gay community.”
How common is HIV in men?Approximately 39.9 million people in the world are HIV-positive, 1.2 million of whom live in the United States.
Globally, men make up about 47% of cases. However, research from 2022 found that men in the United States made up 81% of new cases.
There are a number of reasons for this gender disparity, including:
- systemic homophobia and biphobia
- lack of comprehensive sex education
- lack of education about PrEP and barrier usage
People usually receive an HIV diagnosis after a blood test, but oral fluid or urine tests can also diagnose it.
Most commonly, healthcare professionals will order one of the following tests:
- Nucleic acid test (NAT): looks for viral load in blood
- Antigen/antibody test: looks for both antibodies and antigens in blood
- Antibody test: looks for antibodies in the blood
It typically takes a few days for NAT and antigen/antibody tests to provide results. But there are rapid antibody screening tests and rapid antigen/antibody tests that take 30 minutes or less.
Many medical clinics, community health centers, and substance use programs offer HIV tests.
Another option is to use an at-home HIV test kit. Many of these home tests do not require sending the sample to a lab — a simple oral swab can provide results in 20 to 40 minutes. Regardless of your result, consult with a healthcare professional so that they can confirm with more advanced testing equipment.
Guidelines suggest that everyone between the ages 13 and 64 years get screened for HIV, as you would be tested for any condition as a regular part of routine medical checkups.
But the right cadence for how often you get tested will vary based on your solo and/or partnered sexual activity, the anatomy of your sexual partner(s), and the type of sex had, and intravenous drug use, says Rymland.
However, if you have had sex with different partners, you should, at a minimum,
“If you have had a known exposure to HIV, you should get tested 18 days after that exposure,” explained Rymland. “And you should immediately start taking the HIV-prevention medication PEP, which you can think of as emergency contraception for HIV. It can [help] prevent infection if you begin taking it within 72 hours of exposure.”
You should also get tested
First things first: know your own current STI status.
An estimated 13% of people living with HIV do not know that they have it. Knowing your current STI status can help prevent getting or transmitting the virus to others.
To know your most current HIV status, it’s important to get tested regularly, especially if you have any of the aforementioned symptoms or you feel there’s a possibility you contracted the virus.
If you test HIV-negative, the best way to remain negative is to avoid exposure to bodily fluids that may carry the virus.
These measures can help reduce the risk of contracting HIV:
- Share your current STI and HIV status with any potential partner and ask for theirs: Knowing their status will help you make the most informed decisions.
- Use condoms for any kind of penetration (vaginal, oral, anal): When used correctly, condoms are highly effective at protecting against HIV.
- Try not to share or reuse needles: Many cities have needle exchange programs that provide sterile needles.
- Take precautions: Always assume that blood might be infectious. Use latex gloves and other barriers for protection.
- Talk with your healthcare professional about PrEP: PrEP is a medication that HIV-negative people can take to reduce their risk of contracting HIV if they’re exposed to the virus.
“HIV is absolutely no longer the death sentence it used to be,” said Rymland. “I have taken care of patients that were diagnosed in the 80s who have been on treatment and have never been sick. They live full lives. Today’s treatment for HIV is easy and effective and, if taken properly, a person can live a long and healthy life and not pass it on to partners.”
Indeed,
Getting a prompt diagnosis and early treatment can slow the progression of the infection and significantly improve quality of life. This can improve the outlook for men who have HIV.
Recognizing the early signs and symptoms of HIV is important for timely diagnosis and treatment. Acute HIV infection symptoms can occur across all sexes and genders, and can include flu-like illness, fatigue, swollen lymph nodes, and skin rashes.
With advancements in treatment, including antiretroviral therapy, people living with HIV can lead long and fulfilling lives, but early detection and adhering to a treatment regimen play a big part in managing the condition and maintaining overall health.
Getting tested regularly and using barrier methods when engaging in sexual activity can help prevent the spread of HIV.