Early detection of HIV: Signs and symptoms

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Some people with HIV will experience early symptoms in as little as 2–4 weeks. These symptoms occur as the body’s immune system works to attack the virus, and they typically last from days to weeks.

Some of these symptoms may include:

• ulcers in the mouth
• tiredness
• fever
• sore throat
• swollen lymph nodes or glands
• rash
• aching muscles
• night sweats

Of course, these symptoms could also be signs of another medical condition. Self-testing or at-home testing for HIV is now available, depending on geographical location. However, the only way to confirm an HIV diagnosis is by having a medical professional perform tests. Anyone concerned about their HIV status should get a test as soon as possible.

Most people who do not receive treatment experience three different stages of HIV. However, with modern HIV treatment, it is less common for people to experience the final, most severe stage.

Acute HIV infection

Acute HIV infection is the first stage. It generally begins about 2–4 weeks after contracting HIV.

During this time, people with HIV have many viral particles circling through their bloodstream. This makes it easier for the virus to spread to other people.

People experiencing acute HIV infection may experience the flu-like symptoms listed above. Anyone who thinks they may have experienced exposure to HIV should seek testing, as early diagnosis and treatment can help prevent progression to the next stage.

Chronic HIV infection

Unlike acute HIV infection, the second stage is chronic and can last for decades.

People in this second stage may not experience any symptoms for years. The characteristics of chronic HIV infection include:

• a low level of viral particles in the body replicating at a slow rate
• a decrease in the number of certain immune cells in the body
• the ability to spread HIV

A person with a chronic HIV infection might have fewer symptoms than someone in the acute stage, but people in the chronic stage can still pass the virus to others. Testing, diagnosis, and treatment can keep people from progressing to the final stage of HIV.

AIDS

AIDS, the final stage of HIV, is the most severe. AIDS works against the body’s natural immune system, and people in this stage often have difficulty fighting common infections.

Some symptoms people with AIDS may experience include:

• quick, significant weight loss
• sores in different areas of the body
• chronic diarrhea
• pneumonia
• an ongoing cough
• regular, severe infections

Most people who receive treatment never progress to the final stage. With regular testing and proper care, people with HIV can lead full, healthy lives.

The first report of what came to be known as HIV and AIDS discussed two gay men who died of AIDS in 1981. Throughout the 1980s, AIDS became known as an illness associated with people in the LGBTQIA+ community.

However, researchers now recognize that HIV can affect people of any age, background, or community. Certain experiences can increase the chances of contracting HIV. These may include:

• exposure to or sharing of a contaminated needles and IV drugs
• transfusions with HIV-positive blood
• engaging in unprotected vaginal or anal sex
• a pregnant person passing HIV infection to their child
• exchanging intercourse for money or drugs
• having another sexually transmitted infection, such as syphillis

Fortunately, people with HIV can receive effective treatment that helps keep them and others safe. Through testing and diagnosis, people can live with HIV and help reduce its spread.

There are three main tests for detecting HIV. These tests can detect if a person has HIV about 10–90 days after initial exposure. Each test has a different window period, the time between a person contracting HIV and it becoming detectable through a test.

Nucleic acid testing

Nucleic acid tests find HIV particles in the blood. These tests can detect if a person has HIV within 10–33 days after potential exposure.

However, nucleic acid tests are expensive. Medical practitioners generally perform these tests for individuals with a high likelihood of exposure or people showing signs of acute HIV infection.

Antigen or antibody testing

Antigens are external substances, like virus particles, that enter the body and activate the immune system. Antibodies are the particles the immune system produces to fight infections. This form of testing detects both antigens and antibodies.

Antigen and antibody tests use a finger prick to find signs that a person has HIV. These tests can detect HIV about 18–90 days after initial exposure.

Antibody tests

The final type of test looks for antibodies in the blood. Antibody tests can detect if a person has HIV from around 23–90 days after exposure. The only self-test approved by the Food and Drug Administration (FDA) is an antibody test.

For these tests, medical workers can use blood from the veins, a finger prick, or oral fluid.

No one test is right for every individual. People with a high chance of contracting HIV should speak with a doctor to determine which test to take at a given time.

In 2012, the FDA first approved a fixed-dosed tablet that combines tenofovir disoproxil fumarate and emtricitabine for use as preexposure prophylaxis (PrEP), an antiretroviral medication. PrEP is now available for adults and adolescents who may have a high likelihood of contracting HIV.

This medication can help prevent people from developing HIV infection. Taking the pill once per day reduces the chance of getting HIV during sexual intercourse by about 99%. PrEP is also newly available as an injectable, which a person receives every 2 months.

Anyone with a high likelihood of contracting HIV should talk with a doctor about whether PrEP is right for them.

Other ways to prevent HIV exposure include:

• using condoms during sex
• ensuring that all needles are new and clean before any form of injection
• taking HIV medication while pregnant to avoid newborn HIV infection

Pregnant persons who are HIV-positive should seek medical care early in their pregnancy to receive treatment that can prevent transmission to the fetus.

Finally, individuals who believe they have experienced exposure to HIV should speak with a doctor about post-exposure prophylaxis (PEP). Unlike PrEP, PEP works to prevent HIV infection after exposure.

Taking PEP within 72 hours of exposure can diminish the chance of developing HIV. Individuals should speak with a doctor immediately following an exposure event to maximize PEP’s effectiveness.

Receiving an HIV diagnosis can feel overwhelming. But there are many treatment options available today for people living with HIV.

According to a 2020 study, whereas in the year 2000, people with HIV lived 22 fewer years on average than HIV-negative people in the cohort, by 2016, this had narrowed to 9.5 years for people without major chronic comorbidities.

Today, many people with HIV who receive care can experience a similar lifespan to those without HIV. Paying attention to early signs and symptoms and getting tested regularly are important steps on this journey.

People who suspect they have had an HIV exposure event should contact a doctor as soon as possible.

Anyone experiencing early symptoms of HIV should also consult with a medical practitioner. Early diagnosis and treatment is a crucial step towards long-term health.

Early signs of HIV vary, and not every person with HIV will experience them. The symptoms of HIV become more severe in the later stages of infection.

People who suspect they have experienced exposure to HIV should get tested immediately. A quick diagnosis is an essential step towards effective treatment.

With the right care and treatment regimen, people living with HIV can lead full and healthy lives.