HIV Symptoms in Women: What to Know

HIV can affect people in different ways. For example, females can experience disruptions to their menstrual cycle and vaginal infections.

According to the Office on Women’s Health, 1 in 4 people with HIV in the United States is a woman, while a seven-city report from the Centers for Disease Control and Prevention (CDC) found 42% of transgender women interviewed were living with HIV.

HIV symptoms in females

Most people with HIV experience similar symptoms in the early stages. As the disease progresses, females can have symptoms that affect their menstrual cycles, genitals, and mood.

Symptoms of HIV can appear 2–4 weeks after exposure to the virus. Some of the symptoms that females with HIV experience include:

Flu-like symptoms

In the early stages of an HIV infection, people may experience symptoms resembling the flu, including:

• fever
• tiredness
• coughing and sneezing
• a headache 
• sore throat
• muscle aches

Swollen lymph nodes

Swelling of the lymph nodes can be one of the first signs of an HIV infection. The lymph nodes are small capsules of tissue that help your body fight infection. There are about 800 lymph nodes in your body. 

Lymph nodes often swell in response to infection. When you have an HIV infection, the lymph nodes around your neck, groin, and armpits may swell, causing hard lumps in the area.

The swelling can last from weeks to months. Contact a healthcare professional if your lymph nodes are swollen for more than 2 weeks.

Vaginal infections and pelvic problems

Women with HIV may experience more frequent infections and issues in the vaginal area. These include:

• Repeated vaginal yeast infections: The symptoms of vaginal yeast infection include burning in and around the vagina and vulva, pain during sex, pain when you urinate, and a thick, white vaginal discharge.
• Severe pelvic inflammatory disease (PID): The symptoms of this condition include pain in the lower abdomen, vaginal discharge with an unpleasant smell, fever, and pain and burning when you urinate or have sex
• Higher risk of cervical cancer: Women with HIV are six times more likely to have cervical cancer, according to a 2020 study.

Menstrual irregularities

Some people with HIV may notice a change in their menstrual cycle. These changes may include heavier periods and late or missed periods.

Having HIV may also cause early menopause. Research shows that people living with HIV may experience menopause up to 5 years earlier than people without HIV.

Because HIV affects your immune system, this could affect your hormones and lead to other menstrual cycle symptoms like breast tenderness, cramps, and fatigue. 

Mood changes

As HIV advances, females may experience mood and mental health changes, such as depression, stress, and memory loss. 

Rapid weight loss

HIV can also cause nausea, vomiting, diarrhea, and loss of appetite. This can lead to a rapid loss of weight.

Changes in your skin

Sores and spots can form on your skin, eyelids, mouth, nose, and genitals. These skin lesions can vary in color, from pink and red to purple and brown. 

While HIV can cause skin changes, these may also occur due to co-occurring infections or as a side effect of medications.

HIV experiences in transgender females

Transgender women with HIV may experience similar symptoms as cisgender women. However, transgender women are at higher risk of getting HIV because of factors like social stigma around getting tested, economic vulnerability, and a higher rate of sex without barrier methods.

Transgender women are 49 times more likely to have HIV than the general population.

Barriers to care

Transgender people also face significant barriers to care that may affect diagnosis rates and delay treatment. Healthcare systems often reinforce birth-assigned sex binaries, which can lead to discrimination and stigma against transgender individuals. These large barriers to care may lead to fewer people getting tested or seeking help for HIV out of fear of discrimination or due to poor past experiences in healthcare systems.

HIV and gender-affirming therapy

If a transgender woman is going through gender-affirming therapy, experts recommend that they continue their treatment even when they receive a diagnosis of HIV. A healthcare professional will help to balance HIV treatments with gender-affirming therapies and monitor a person’s progress.

PrEP access

Pre-exposure prophylaxis (PrEP) is a preventive treatment for HIV. PrEP is available as a pill or an intravenous injection and can effectively prevent HIV.

However, studies show that awareness of PrEP is low among women, and doctors are often hesitant to prescribe it. Some transgender people undergoing gender-affirming therapy may also have concerns about PrEP’s interaction with their care. However, there are no known drug interactions between PrEP and hormone therapies.

Further education is necessary among clinicians regarding PrEP and transgender experiences, and awareness of the treatment’s efficacy for women requires improvement.

What treatments are available?

Treatment for HIV is known as antiretroviral therapy. Antiretroviral therapy consists of taking a combination of HIV medications that can help slow or stop the progression of HIV. HIV medications in an antiretroviral therapy include:

• emtricitabine (Emtriva)
• etravirine (Intelence)
• nevirapine ER (Viramune)
• raltegravir (Isentress HD)
• ritonavir (Norvir)
• efavirenz (Sustiva)
• zidovudine (Retrovir)

If you need help covering the cost of medications, the free Optum Perks Discount Card could help you save up to 80% on prescription drugs. Plus, you can now get them delivered to your home in as little as 3 days. Search for your medication here.

Early diagnosis, continuous monitoring of your symptoms, and adherence to your treatment are key to managing the condition. Remember, you can live a healthy life with an HIV diagnosis.

Summary

HIV affects people differently. Females with HIV can have different and additional symptoms than males. In addition to flu-like symptoms and swollen lymph nodes, females with HIV can experience changes in their menstrual cycle and more vaginal yeast infections. They also have an increased risk of cervical cancer.

Transgender women with HIV have similar symptoms to cisgender women. But transgender women have a higher risk of getting HIV due to stigma, discrimination, and barriers to care.

Treatment for HIV consists of antiretroviral therapy, which can help slow or stop the progression of HIV. Talk with your healthcare professional about the best treatment for your unique needs and how to manage the symptoms that may develop.

Download the free Optum Perks Discount Card to save up to 80% on many prescription medications. Plus, you can now get them delivered to your home in as little as 3 days. Search for your medication here.