HIV is a virus that attacks the body’s immune system, destroying a specific type of cell that helps the body fight off infections and diseases. In the United States, a higher number of cisgender men are living with the virus than cisgender women.

Cisgender refers to a gender identity that a person, or society, deems to match the sex that a doctor assigned them at birth.

People who do not identify with their assigned sex may refer to themselves as trans, including gender identities such as transgender and nonbinary.

There is limited research on the early signs and symptoms of HIV in transgender men and nonbinary people. This article focuses on the early signs and symptoms of HIV in cisgender men alongside testing, diagnosis, and treatment.

Share on Pinterest
Simone Wave/Stocksy

Early symptoms of HIV in cisgender men are often vague and unspecific.

In cisgender men, initial HIV symptoms are typically unspecific. Early symptoms are usually bearable and frequently mistaken for flu or another mild condition. People may easily underestimate them or mistake them for minor health conditions.

Limited research is available on HIV symptoms in transgender men and nonbinary people. In addition to the early signs and symptoms listed below, transgender men and nonbinary people who were assigned female at birth may have additional symptoms of an HIV infection.

Cisgender people can experience flu-like symptoms some days to weeks after contracting the virus, which may include:

Besides flu-like symptoms, some people may also experience more severe symptoms early on, such as:

Less common early HIV symptoms include:

People may undervalue initial symptoms and delay consulting a doctor until the symptoms worsen, by which time the infection might have advanced.

The fact that some cisgender men do not seek timely treatment may be why the virus affects them more severely than cisgender women.

While transgender men and cisgender men have many of the same early signs and symptoms of HIV, trans men may experience additional symptoms, such as genital yeast infections and changes in menstruation.

Although scientists and researchers have made significant progress in the prevention and treatment of HIV over the last decades, it remains a serious health problem in most countries around the world.

According to the Centers for Disease Control and Prevention (CDC), in 2019, an estimated 36,801 people were diagnosed with HIV in the United States.

Although the number of new diagnoses fell by 9% between 2015 and 2019, there were still approximately 1.2 million people in the U.S. living with HIV in 2019.

Cisgender men are more likely than cisgender women to be living with HIV. By the end of 2019, 76% of all people with the virus in the U.S. were male. Most new diagnoses that year were also in men — more than 30,000, representing 81% of all new diagnoses.

Some groups of people are affected more by HIV than others. In fact, in 2019, 65% of all new diagnoses were a result of male-to-male sexual contact. An additional 4% were associated with male-to-male sexual contact and injection drug use.

By race and ethnicity percentage of new HIV diagnoses:

  • 42% of Black/African American people
  • 29% of white people
  • 25% of Hispanic/Latino people
  • 2% of multiracial people
  • 1% of American Indian/Alaskan Native people
  • < 1% of Native Hawaiian and Other Pacific Islander people

According to a 2021 CDC report, 4 in 10 transgender women surveyed in U.S. major cities have HIV, with the highest rates of HIV transmission for trans women who identify as Black or Latinx. Transgender men have an HIV positivity rate of 3.2% compared to less than 0.5% of the general population. Limited research is available regarding HIV positivity rates for nonbinary people.

HIV progresses through three stages. Each stage has particular characteristics and symptoms.

Stage 1: Acute phase

This stage usually occurs 2–4 weeks after transmission, and not every person will notice it.

Typical symptoms are similar to flu and may include fever, sickness, and chills. Some people do not realize that they have the virus because their symptoms are mild, and do not feel sick.

At this stage, a person will have a significant amount of virus in their bloodstream, which means that it is easy to pass it on. If a person thinks that they might have the virus, they should seek medical attention as soon as possible.

Stage 2: Clinical latency

This stage can last for 10 years or more if the person does not receive treatment. It is marked by an absence of symptoms, which is why medical professionals may also refer to this phase as the asymptomatic phase.

At this stage, a medication called antiretroviral therapy (ART) can control the virus, meaning that HIV does not progress. It also means that people are less likely to transmit the virus to others.

While the virus is still reproducing in the bloodstream, it may do so at levels that healthcare professionals cannot detect. If someone has undetectable levels of the virus for at least 6 months, they cannot pass the virus to others via sex.

During this phase, HIV is still multiplying inside the body but at lower levels than in the acute phase.

Stage 3: AIDS

This is the most severe stage, during which the amount of virus in the body has devastated the body’s population of immune cells. Typical symptoms of this stage include:

  • fever
  • sweat
  • chills
  • weight loss
  • weakness
  • swollen lymph nodes

At this stage, the immune system is very weakened. This allows opportunistic infections to invade the body.

In the U.S., most people infected with HIV do not progress to AIDS. This is because they are receiving ART treatment.

In rare cases, it is possible for HIV infection to progress to AIDS rapidly.

Doctors diagnose HIV by testing a blood or saliva sample, although they could also test a urine sample. This test looks for antibodies produced by the person to fight the virus. The test typically takes around 3 to 12 weeks to detect antibodies.

Another test looks for HIV antigens, which are substances that the virus produces immediately after transmission. These antigens cause the immune system to activate. HIV produces the p24 antigen in the body even before antibodies develop.

Usually, both the antibody and the antigen tests are performed in labs, but there are also home tests that people can take.

Home tests may require a small blood or saliva sample, and their results are quickly available. If the test is positive, it is essential to confirm the results with a doctor. If the test is negative, a person should repeat it after a few months to confirm the results.

People who are sexually active should get tested for HIV at least once in their lifetime as part of their routine health care.

The CDC recommend that everyone between the ages of 13 and 64 should take an HIV test.

The CDC also recommend that people with specific risk factors should take a test at least once a year. This recommendation applies to sexually active gay and bisexual men and users of injectable drugs.

Besides these formal recommendations, everyone who may have been exposed to HIV or had sex without a condom should also take a test.

HIV is a virus that weakens the immune system and leaves the body more prone to opportunistic diseases and infections.

Although there is no cure for HIV, medication can control it. People with the virus can live healthy lives with proper medical care and medication.

Early diagnosis and appropriate treatment can help slow the progression of the virus and significantly improve quality of life.

Being able to spot the early signs can help a person receive a quick diagnosis.

Read the article in Spanish.

For more in-depth information and resources on HIV and AIDS, visit our dedicated hub.