• Signs and Symptoms

The symptoms of HIV vary, and many people who are infected with HIV do not show any signs or symptoms. Some early symptoms may include:

• Fever (this is the most common symptom)
• Swollen glands
• Sore throat
• Rash
• Fatigue
• Muscle and joint aches and pains
• Headache

These symptoms can last anywhere from a few days to several weeks. However, you should not assume you have HIV if you have any of these symptoms. Each of these symptoms can be caused by other illnesses. Remember, many people who are infected with HIV do not have any symptoms for 10 years or more. If you have HIV and you are not taking HIV medication (antiretroviral therapy), eventually the virus will weaken your body’s immune system.

The onset of symptoms signals the transition from HIV to AIDS (Acquired Immunodeficiency Syndrome). Many of the severe symptoms and illnesses of HIV disease come from the opportunistic infections that occur because your body’s immune system has been damaged. During this late stage of HIV infection, people infected with HIV may have the following symptoms:

• Rapid weight loss
• Recurring fever or profuse night sweats
• Extreme and unexplained tiredness
• Prolonged swelling of the lymph glands in the armpits, groin, or neck
• Diarrhea that lasts for more than a week
• Sores of the mouth, anus, or genitals 
• Pneumonia
• Red, brown, pink, or purplish blotches on or under the skin or inside the mouth, nose, or eyelids
• Memory loss, depression, and other neurologic disorders.

Each of these symptoms can be related to other illnesses; the only way to know for sure if you are infected with HIV is to get tested.

Transmission (How it Spreads)

You can get or transmit HIV only through specific activities. Most commonly, people get or transmit HIV through sexual behaviors and needle or syringe use. Only certain body fluids—blood, semen (cum), pre-seminal fluid (pre-cum), rectal fluids, vaginal fluids, and breast milk—from a person who has HIV can transmit HIV. These fluids must come in contact with a mucous membrane or damaged tissue or be directly injected into the bloodstream (from a needle or syringe) for transmission to occur. Mucous membranes are found inside the rectum, vagina, penis, and mouth.

In the United States, HIV is spread mainly by:

• Having anal or vaginal sex with someone who has HIV without using a condom or taking medicines to prevent or treat HIV.
  • For the HIV-negative partner, receptive anal sex (bottoming) is the highest-risk sexual behavior, but you can also get HIV from insertive anal sex (topping).
• Either partner can get HIV through vaginal sex, though it is less risky for getting HIV than receptive anal sex.
• Sharing needles or syringes, rinse water, or other equipment (works) used to prepare drugs for injection with someone who has HIV. HIV can live in a used needle up to 42 days depending on temperature and other factors.

Less commonly, HIV may be spread:

• From mother to child during pregnancy, birth, or breastfeeding. Although the risk can be high if a mother is living with HIV and not taking medicine, recommendations to test all pregnant women for HIV and start HIV treatment immediately have lowered the number of babies who are born with HIV.
• By being stuck with an HIV-contaminated needle or other sharp object. This is a risk mainly for health care workers.

• In extremely rare cases, HIV has been transmitted by:
  Oral sex—putting the mouth on the penis (fellatio), vagina (cunnilingus), or anus (rimming). In general, there’s little to no risk of getting HIV from oral sex. But transmission of HIV, though extremely rare, is theoretically possible if an HIV-positive man ejaculates in his partner’s mouth during oral sex. To learn more about how to lower your risk, visit the CDC's Oral Sex and HIV Risk webpage.
• Receiving blood transfusions, blood products, or organ/tissue transplants that are contaminated with HIV. This was more common in the early years of HIV, but now the risk is extremely small because of rigorous testing of the US blood supply and donated organs and tissues.
• Eating food that has been pre-chewed by an HIV-infected person. The contamination occurs when infected blood from a caregiver’s mouth mixes with food while chewing. The only known cases are among infants.
• Being bitten by a person with HIV. Each of the very small number of documented cases has involved severe trauma with extensive tissue damage and the presence of blood. There is no risk of transmission if the skin is not broken.
• Contact between broken skin, wounds, or mucous membranes and HIV-infected blood or blood-contaminated body fluids.

Deep, open-mouth kissing if both partners have sores or bleeding gums and blood from the HIV-positive partner gets into the bloodstream of the HIV-negative partner. HIV is not spread through saliva.