Recognizing HIV Symptoms in Women: A Comprehensive Guide

Medically Reviewed by Zilpah Sheikh, MD on July 22, 2024
Written by Stephanie Watson
6 min read

The symptoms of HIV are mostly the same for both sexes. But there can be some differences. Women and people assigned female at birth (AFAB) are more likely to get yeast infections and changes to their menstrual periods. Men and people assigned male at birth (AMAB) may have erection problems, lose their sex drive, and develop inflammation of their rectum called proctitis.

Common HIV symptoms in both sexes include:

  • Fever

  • Headache

  • Muscle aches and joint pain

  • Swollen glands and lymph nodes

  • Night sweats

  • Weight loss

  • Diarrhea

  • Sore throat and mouth sores

  • Rash

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

Changes in your period. You may have lighter or heavier bleeding, skipped periods, or 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.

Bacterial vaginosis. This is caused by an imbalance in bacteria in your vagina. You might have:

  • Vaginal discharge 

  • Vaginal pain and itching

  • Burning when peeing

  • Thin, watery discharge 

  • Strong, fishy, vaginal odor

Symptoms related to sexually transmitted diseases (STDs). Genital herpes, pelvic inflammatory disease (PID), and chancroid may show up more often and have more severe symptoms.

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

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 days to a few weeks.

Symptoms of a new HIV infection include:

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.

HIV and thrush

Men and women with HIV are at higher risk for 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. Thrush is usually harmless and is treatable with the antifungal medicine, fluconazole (Diflucan). 

Another way to treat oral thrush is to practice good oral hygiene by brushing your teeth and rinsing with mouthwash. Taking antiretroviral therapy (ART) to treat HIV should prevent thrush infections.

HIV skin changes

About 90% of people with HIV will notice skin changes at some point, including lesions, shingles, or a rash. The skin may look red and be covered in small bumps. Sores on your mouth or vagina are signs of a herpes infection. Other infections cause white spots on the tongue or cheeks. Red, purple, brown, or pink splotches can form on the skin inside your mouth, nose, or eyelids.

These symptoms happen because the virus weakens your immune system and leaves you at risk for infections like herpes. The skin changes could also be a reaction to some of the medicines that treat HIV infection.

HIV symptoms are the same, whether or not you’re pregnant. Getting treated can protect your baby from HIV infection. Tell your doctor if you have symptoms of HIV, or if you think you were exposed to the virus during sex or drug use. 

The earlier you get tested, the sooner you can start on treatment. If you didn’t get tested in pregnancy, you can still get an HIV test during labor and delivery. Having a C-section can prevent HIV from spreading to your baby during labor. Your baby can also get treated after birth to reduce their risk of HIV infection.

HIV-positive pregnant women are 54% more likely to have human papillomavirus (HPV) than pregnant women without HIV. HPV is a sexually transmitted infection that causes genital warts and increases the risk for cancers of the cervix, vagina, vulva, throat, and anus. 

Usually, HPV isn’t dangerous to the growing baby. But genital warts may grow faster during pregnancy. Rarely, the HPV infection could pass to the baby during birth. During pregnancy, HPV might also increase the risk for early labor. 

If you think you might have been exposed to HIV, your OB/GYN can test you for HPV. 

After having flu-like symptoms in the first few weeks, you’ll go into what doctors call the clinical latency stage. Other names for this stage are asymptomatic HIV infection or chronic HIV infection. 

The virus will still make copies of itself in your body, but much more slowly. You’ll start to feel better. Most people don’t have any symptoms during this stage, which can last up to 15 years.

 

AIDS is the final stage of HIV infection. HIV can progress to AIDS without treatment. In this stage, the immune system is badly damaged. 

The number of CD4 cells, immune cells that protect your body from infections, drops below 200 cells per cubic millimeter of blood (200 cells/mm3). In contrast, a person with a healthy immune system has a CD4 count between 500 and 1,600 cells/mm3. 

Symptoms of AIDS in women include:

  • Fever or night sweats that keep coming back
  • Diarrhea that lasts more than a week
  • Sudden weight loss
  • Extreme tiredness that doesn’t have another cause
  • Swollen glands in the armpits, neck, or groin
  • Sores on the mouth, vagina, or butt
  • Red, brown, purple, or pink splotches on the skin inside the mouth, nose, or eyelids
  • Depression
  • Memory loss

These can be symptoms of many different conditions. It’s important to see a doctor to confirm the diagnosis.

HIV symptoms are mostly the same in men and women. Some women may have changes to their periods or more yeast infections, plus more typical HIV symptoms like fever, tiredness, and night sweats. If you think you’ve been exposed to HIV, see your doctor for a test. It’s especially important to get tested if you’re pregnant or you plan to get pregnant because you can pass HIV to your baby.

How do you know if a female has HIV?

The typical symptoms of HIV in men and women include tiredness, rash, fever, and night sweats. Women or those assigned female at birth may also have symptoms like lighter or heavier periods, yeast infections, and lower belly pain.

How long can you have HIV without noticing?

Some people develop symptoms a month or two after an HIV infection. Others may not notice symptoms for 10 years or more. How soon symptoms appear depends on how quickly the virus damages the immune system.

How do HIV-positive nails look?

Nail changes are common in people with HIV. Often a fungus or other infection causes these changes. The nails may turn brown or black, develop white spots or lines, become brittle and split, or get wider and rounder (clubbing).