HIV symptoms may differ in females. As well as flu-like symptoms and skin changes, they may notice menstrual disruption, more frequent vaginal infections, and mood changes.

The Centers for Disease Control and Prevention (CDC) estimate that more than 7,000 women in the United States received an HIV diagnosis in 2018.

Additionally, a 2021 CDC report found that 4 in 10 transgender women surveyed in seven major U.S. cities have HIV, with two-thirds of African American/Black transgender women and one-third of Latinx transgender women reporting being HIV positive.

Below, we describe HIV symptoms in females, how doctors diagnose the condition, and what treatment options are available.

A note about sex and gender

Sex and gender exist on spectrums. This article will use the terms “male,” “female,” or both to refer to sex assigned at birth. Click here to learn more.

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Within a few weeks of contracting HIV, the body goes through seroconversion, a period in which the virus rapidly multiplies.

During seroconversion, the virus can cause a flu-like illness called an acute HIV infection.

After this initial period, further symptoms can develop, especially if a person does not receive treatment.

Symptoms of HIV in females can include:

Flu-like symptoms

After a person contracts HIV, their immune system responds to the virus.

Symptoms may include:

  • fatigue
  • headache
  • a low grade fever
  • coughing
  • sneezing
  • a runny nose or congestion

The symptoms above usually appear 2–4 weeks after contracting HIV, and they can last anywhere from a week to a month.

These symptoms can resemble those of a cold or flu, so a person may not initially associate them with HIV.

Swollen lymph nodes

Swollen lymph nodes can be one of the earliest symptoms of HIV after an acute infection.

Following an acute HIV infection, the virus continues to multiply at a slower rate. A person may or may not have symptoms.

Treatment can slow or stop the virus’ progression. Even without treatment, some people experience no additional symptoms for up to a decade after the initial infection.

The neck may feel swollen just under the jaw and behind the ears. The swelling can cause trouble swallowing and may last anywhere from a few days to months.

Rapid weight loss

If a person is not receiving HIV treatment, the virus can cause nausea, diarrhea, poor food absorption, and appetite loss.

Each of these issues can cause a person to lose weight quickly.

Changes in mood

Sometimes, HIV progression can cause mood changes and neurological disorders in people assigned female at birth.

This may involve depression, which can cause feelings of hopelessness and intense sadness. People may also experience stress and memory loss.

Skin changes

HIV can cause unusual spots to form on the skin. They may be red, pink, brown, or purple. These spots may appear inside the mouth, eyelids, or nose.

Sores can also develop on the mouth, genitals, or anus.

Menstrual changes

Some people who menstruate and who have HIV notice lighter or heavier periods. If a person is experiencing rapid weight loss, they may also begin to miss periods.

In addition, hormonal fluctuations can cause menstrual symptoms such as cramps, breast tenderness, and fatigue to change or get worse.

It is important to note that menstrual changes are common and not necessarily a sign of HIV. But if they present with other symptoms, an HIV screening may be warranted.

Vaginal yeast infection

HIV can increase the risk of developing vaginal yeast infections. Symptoms of these infections include:

  • burning in and around the vagina and vulva
  • pain during sex
  • painful urination
  • thick, white vaginal discharge

While almost all people who have a vagina have yeast infections from time to time, HIV can cause these infections to occur more frequently.

When a person has HIV, their immune system uses a lot of energy to respond to the virus. As a result, their body is not as equipped to combat other infections.

It is important to note that even recurrent yeast infections are very common in people with a vagina. They are not a hallmark sign of HIV and are more common in diabetic people. That said, persistent yeast infections may warrant an HIV screening, especially if they happen at the same time as other symptoms.

HIV-positive transgender females experience many of the same symptoms as cisgender females. This includes flu-like symptoms, swollen lymph nodes, rapid weight loss, skin changes, and mood changes.

While there is some research that there may be interactions between antiretroviral therapy to treat HIV and feminizing hormone therapy, it is recommended that transgender females continue gender-affirming care after a diagnosis of HIV.

The CDC recommends that everyone ages 13–64 get tested for HIV at least once as part of routine care. They advise everyone pregnant to take an HIV test.

Some people have a higher risk of contracting HIV. Risk factors include:

  • having vaginal or anal sex with a person who either does not know their HIV status or who has HIV and is not taking antiretroviral medications
  • injecting drugs and sharing needles or syringes
  • having a sexually transmitted infection, such as syphilis
  • being transgender females who have sex with males who have male sexual partners
  • being a female who engages in sex work

If a person has any of the above risk factors, they should talk with their doctor about HIV testing. The doctor should also advise about how often to take a test.

Early diagnosis is crucial, and many therapies can help a person manage HIV without complications.


According to the CDC there were almost 7,000 new diagnoses of HIV in the U.S. and U.S.-dependent areas among young women in 2019. This figure represents 19% of the total diagnoses in those areas for that year.

There were 37,801 total new HIV diagnoses in the U.S. and U.S.-dependent areas in 2019. Of that number, 2% were among transgender people. According to a 2022 Pew Research Center survey, about 1.6% of all U.S. adults identify as transgender or nonbinary.

Different types of tests can help a doctor diagnose HIV. Some tests cannot detect the virus in its early stages.

HIV tests include:

  • Antibody tests: These detect the presence of HIV antibodies, or immune system proteins, in blood or saliva samples. Rapid and at-home tests are usually antibody tests. They cannot detect HIV at an early stage.
  • Antigen/antibody tests: These detect HIV antibodies and antigens, or viral components, in the blood. Antigen/antibody tests also cannot detect HIV at an early stage.
  • Nucleic acid tests: These look for the presence of HIV’s genetic material in the blood, and they can detect HIV at an early stage.

Anyone who may have contracted the virus and who has early symptoms may wish to speak with their doctor about a nucleic acid test.


While there is currently no cure for HIV, doctors can prescribe medications that either stop the virus from replicating or reduce the rate at which the virus multiplies.

These medications are called antiretroviral therapies, and there are several types.

A person may need to take between one and three medications a day, depending on their needs.

Ideally, if a person takes antiretroviral therapies as instructed, the virus will stop replicating, and the immune system can manage those that remain.

Levels of the virus may diminish until they are no longer detectable. But HIV remains in the body, and if a person stops taking their medications, the virus could start to replicate again.

These medications could use different regimens but can be given as a once-a-day combination pill (it is very rare for patients to get multiple separate drugs).

Learn more about the different treatments for HIV here.

HIV symptoms can resemble those of other illnesses. Initial symptoms may be similar to those of the flu, for example.

Anyone who thinks they may have HIV should speak with a doctor about testing.

Thanks to innovations in treatment, people can manage HIV much like any other chronic condition. This can help prevent late-stage symptoms.