HIV: Signs and Symptoms in Women
What Are The Symptoms Of HIV In Females?
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.
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 symptomsAfter a person contracts HIV, their immune system responds to the virus.
Symptoms may include:
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 nodesSwollen 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 lossIf 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 moodSometimes, 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 changesHIV 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 changesSome 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 infectionHIV can increase the risk of developing vaginal yeast infections. Symptoms of these infections include:
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:
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.
DiagnosisAccording 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:
Anyone who may have contracted the virus and who has early symptoms may wish to speak with their doctor about a nucleic acid test.
TreatmentWhile 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.
HIV AIDS Control Tips: Different Types Of HIV Tests, And Their Importance In Managing Symptoms
VERIFIED HIV AIDS Control Tips: Different Types of HIV Tests, and Their Importance In Managing Symptoms Are You Suffering from HIV AIDS? Take a look at these important HIV tests that can help you manage the symptoms. HIV tests are broadly categorized into screening, confirmation, or treatment monitoring. All tests for HIV screening and confirmation of diagnosis should include pretest counseling before performing the tests and post-test counseling before disclosing the results. It may be necessary to refer the patient to appropriate services such as HIV specialists and Integrated Counseling and Testing Centers (ICTC) following NACO guidelines.
We spoke to Dr. Niranjan Patil, AVP, and Scientific Business Head - Infectious Diseases, Microbiology & Molecular Biology- Head & Biosafety officer, Metropolis Healthcare Limited, to understand more about HIV screening and different ways in which this condition can be managed.
Tests for HIV screeningIn India, HIV screening is conducted following the NACO guidelines for HIV testing. Serological tests, such as HIV1 and 2 antibody tests, can be performed. For individuals aged over 18 years who are clinically asymptomatic, the sample should react to HIV antibodies with three different kits (Strategy III) as per NACO guidelines. Antibody-based tests can take various forms, such as ELISA, CMIA, CLIA, ELFA, lateral flow immunochromatography-based rapid tests, immunofiltration, etc.
Currently, 4th generation assays based on antigen-antibody interactions can be performed, reducing the window period for detection. The window period for antibody-based tests is the time gap between the entry of the HIV virus into the human body and the appearance of detectable antibodies in human serum or plasma samples. This period may vary from 6 weeks to 6 months from person to person, depending on various factors. During the window period, HIV antibody tests may yield false-negative or non-reactive results. HIV antigen-based or HIV PCR-based tests may be recommended for HIV diagnosis during this window period for antibody-based tests.
For newborn infants and children under 18 months of age, maternally acquired antibodies may interfere with antibody-based serological screening tests for HIV. It is recommended to perform nucleic acid-based qualitative tests such as HIV1 proviral DNA PCR, HIV2 RNA PCR, or HIV p24 antigen tests. NACO recommends the use of a dried blood sample to perform DNA PCR tests between 6 weeks to 18 months of age for the diagnosis of HIV in infants.
HIV Tests For ConfirmationAn HIV 1 and 2 western blot test may be performed, which looks for various proteins of HIV1 and 2. However, it has a longer window period of detection compared to the screening tests and is recommended to be performed for confirmation of the screening results obtained from the antibody-based tests.
Alternatively, HIV testing can be conducted using nucleic acid-based tests such as HIV1 RNA PCR and HIV2 RNA PCR.
HIV tests for treatment monitoring
For known HIV-positive patients who are consuming HIV anti-retroviral agents, viral load tests such as HIV-1 and HIV-2 quantitative viral load tests, which look for HIV RNA viral copies, are used to monitor the response to treatment. These viral load-based tests may be performed at 6-month intervals to assess prognosis. Additionally, tests such as CD4 counts may be used as an additional parameter to monitor the response to anti-viral treatment.
Apart from these, there are tests meant for the detection of resistance to anti-retroviral agents referred to as HIV drug resistance tests, which may be genotypic or phenotypic. Generally, HIV genotypic tests involve DNA/RNA sequencing, which includes performing PCR followed by sequencing of the nucleic acid. This is followed by comparing the sequence obtained with a standard database using sophisticated software algorithms. These HIV drug resistance tests help the HIV specialist doctor choose and alter anti-HIV medications during the course of treatment for an individual patient.
Metropolis has been a pioneer in HIV testing in the private diagnostics sector for more than three and a half decades now and has been an active partner with NACO and the Government of India for HIV viral load testing.
HIV In Older People: 'I Thought It Was A Young Person's Illness'
By Rachel StonehouseVictoria Derbyshire programme & Inside Out West
Ashley received a late diagnosis of HIVWhen 59-year-old Ashley was in hospital with appendicitis, neither Ashley nor the doctors considered HIV.
"They said there's nothing wrong with you, you've had a virus - not knowing that I'd still got the biggest virus you could possibly get," Ashley recalls.
Ashley was diagnosed with HIV three years ago, after having unprotected sex.
But the late diagnosis meant the virus had already started to damage Ashley's immune system.
"It was pretty much touch and go."
Ashley's experience isn't unusual - six out of 10 over-50s with HIV received a late diagnosis in 2018, according to figures from Public Health England (PHE).
Health professionals and charities say both the stigma and misconception that older people are not sexually active means symptoms are not always picked up.
"Over-50s, people who've come out of divorce, or marriage, they think they're safe," Ashley says.
"Because nobody can get pregnant anymore, 'there's no danger'.
"Because 'those illnesses are for young people'. But they're not, they're for everybody."
'You think you're invincible'Figures obtained by the Victoria Derbyshire programme from PHE show rates of sexually transmitted infections (STIs) in the over-45s have increased by about a third in the past five years.
Norah O'Brien, a sexual health expert from PHE, says older people themselves often don't perceive themselves to be at risk.
It is a view echoed by 63-year-old Karen Norton, who contracted HIV a number of years ago in Africa.
"The majority of us all believe we're invincible and it'll never happen to us," she says.
Karen contracted HIV in Africa a number of years ago"Professionals sort of assume that an over 50-year-old wouldn't have this illness.
"It's an assumption that I think is generally something we all make about over 50-year-olds.
"You don't really like to think of your mother or father having this - but it's so possible."
Karen took a long time to open up about her diagnosis, fearing she would be judged.
"You feel as if you're carrying a dirty secret that you have to hide," she says.
"If you have unprotected sex then it can happen to you. I'm a living example."
'Not a death sentence'Last month, figures showed the number of people diagnosed with HIV in the UK had dropped substantially since 2012 - particularly among gay and bisexual men.
In response, the Terrence Higgins Trust said a focus was now needed beyond communities stereotypically associated with HIV.
Aled Osborne, from Brigstowe, which is a Bristol-based charity supporting people affected by HIV, says those in the over-50s bracket may wrongly believe HIV is a "gay disease".
Older people still remember the HIV/Aids campaigns of the 80s and 90s, he says, and they haven't necessarily received correct information since.
"Living with HIV now is not the death sentence it was in the 80s and 90s. We have effective treatment," he said.
"People living with HIV who are on effective treatment cannot pass the virus on."
'Bitter'The life expectancy of those prescribed anti-retroviral drugs at an early stage is in line with that of the general population.
But late-stage infections have more than a tenfold increased risk of death in the year following diagnosis compared with those who are diagnosed early and begin treatment immediately.
Ashley has struggled with the late diagnosis.
"I didn't mind being HIV positive. I don't mind it at all. But it was just that delay - that they didn't find it," Ashley says.
"It was so long… and the damage done to my body - I'm a little bit bitter about."
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