Question:

How do you know if you have HIV/AIDS? Are there any symptoms? 

Answered by: Daniel Cramer, APRN-NP, Infectious Disease Nurse Practitioner focusing specifically on HIV care.

We generally do not use the term “AIDS” anymore. We prefer a less stigmatizing term advanced HIV, a stage of chronic HIV infection that happens when CD4 cells have been depleted low enough that the body is susceptible to opportunistic infections. With appropriate treatment, advanced HIV is generally no longer a lifelong diagnosis and can, in most cases, rebuild the immune system. 

Signs and symptoms of early- to mid-stage HIV infection.

In the early stages, HIV symptoms are often nonexistent or mild. They can be confused with a mild illness that generally resolves. That said, most people infected with HIV experience a short, flu-like illness two to six weeks after infection. After this, HIV may not cause any symptoms for several years. This stage of the infection is called acute HIV infection. Advancements in HIV detection have allowed us to generally detect infection as soon as 10 days after exposure to the HIV virus.

The most common symptoms at this stage are fever, body rash and sore throat. Other symptoms may include tiredness, joint pain, muscle pain or lymphadenopathy. Generally, most people will not have symptoms after acute HIV infection.  This is what makes HIV so dangerous; there are generally no discernable symptoms related to HIV infection following acute HIV infection. Most symptoms will appear in later stages, as HIV damages an individual’s immune system. 

Advanced HIV symptoms: A result of a severely impaired immune system.

Everyone is different, but advanced HIV symptoms can appear as late as 10 years after infection. While symptoms vary, the most common symptoms of advanced HIV are weight loss, night sweats, recurrent infections, chronic diarrhea, changes to your skin (rash, mucosal changes such as in the mouth or gums), trouble swallowing and shortness of breath. 

Speak to your doctor immediately If you believe you may have been exposed to HIV or any other STI through unprotected sexual activity. 

Ideally, every person should speak to their doctor before engaging in unprotected sexual activity and discuss pre-exposure prophylaxis (PrEP) based on their risk. Every sexually active individual would benefit from a discussion with their provider about sexual health, despite gender or sexual orientation.

Suppose a patient is told by a previous partner they are infected. In that case, they should contact their provider within three days of sexual activity to consider PEP (Post-exposure prophylaxis), which is highly effective in preventing infection.  PEP does not prevent 100% of HIV infections, but it is very effective at preventing HIV if prescribed and taken correctly. Observational research suggests that PEP can reduce the risk of getting HIV by more than 80%. Patients can speak to any Nebraska Medicine health care provider who can either prescribe PEP or be referred to a provider who will prescribe PEP promptly following possible exposure to HIV.

Being open and honest with your provider is essential to receiving the full spectrum of health care.

Historically, HIV has been stigmatizing, making many patients feel ashamed due to the social and professional stigma of talking about their risk. But if you withhold information from your provider, large swaths of your health care may not be addressed. Nebraska Medicine is committed to changing how people feel about discussing sexual activity and the risk of STI transmission. We now know that this infection can infect anyone, so we recommend:

• Getting an HIV test at least once in your life
• Those who are sexually active get HIV tests along with their routine STI screening.