Of the 1.2 million people living with human immunodeficiency virus (HIV) in the United States, 13 percent don’t know they have it. Although some symptoms of the condition are well known, others may be less of a red flag, delaying necessary diagnosis and treatment. This has led some people to wonder if a sore throat and HIV might be connected — is it a symptom or early sign of HIV?

Read on to discover the most common early symptoms of HIV, particularly a sore throat.

Recognizing Early Symptoms of HIV

Acute HIV infection is the earliest stage of infection. During this period, 50 percent to 90 percent of people with HIV have flu-like symptoms that may last a few days to several weeks. The exact percentage of people who experience symptoms may be even lower due to research limitations. Symptoms typically develop within two to four weeks of infection and result from the body’s initial reaction to the virus.

How Long Does the HIV Acute Stage Last?

The acute stage of HIV infection usually spans several weeks, generally resolving within a month after initial infection. During this time, the immune system is reacting to the virus, which may cause flu-like symptoms for some people. Once this stage passes, HIV enters a longer, chronic phase that can last for years without noticeable symptoms.

What Are the First Signs of Contracting HIV?

When it comes to the signs and symptoms of acute HIV, researchers don’t know their exact prevalence (how widespread they are). However, available research points to a handful of symptoms that occur most often. Some of the symptoms of early HIV infection can affect your throat. These are sometimes called HIV throat symptoms. The first signs and symptoms of HIV, from most to least common, are:

• Fever
• Fatigue
• Muscle aches and joint pain
• Swollen lymph nodes
• Headache
• Sore throat
• Rash

Other possible symptoms include:

• Painful mouth sores
• Genital ulcers
• Weight loss
• Aseptic meningitis (inflammation of the lining around the spinal cord, usually caused by viruses)
• Pain in the back of the eyes
• Depression
• Belly pain
• Cough
• Diarrhea
• Night sweats

Although sore throat is commonly reported, acute HIV symptoms and their severity vary widely, and some people have no symptoms at all. Additionally, early symptoms of HIV, including sore throat, are nonspecific, which means they also occur in many other conditions. Some people ask, “How bad is HIV sore throat?” It can feel like a bad cold or flu, but not everyone has the same experience.

Is It Acute HIV or Another Condition?

Knowing about the other conditions that can cause sore throat may help you and your provider differentiate them from acute HIV. Viral infections cause sore throat in 50 percent to 80 percent of cases. The most common of these viruses are:

• Rhinovirus (causes the common cold)
• Orthomyxovirus (causes influenza)
• Adenovirus
• Coronavirus
• Parainfluenza

These viruses, unlike HIV, are usually cleared by a person’s immune system without causing long-term issues. HIV is among the less common viruses that cause sore throat, along with herpes virus, Epstein-Barr virus (which causes mononucleosis), and Coxsackievirus.

Bacterial infections can also cause sore throats. These less common infections are typically more serious and may develop after a viral infection.

The most common bacterial cause of sore throat is Group A strep, which accounts for between 5 percent and 36 percent of acute pharyngitis (sore throat) cases. Other common, noninfectious causes of sore throat include allergies, dry indoor air, outdoor air pollution, throat muscle strain, and gastroesophageal reflux disease. These factors can affect people with and without HIV.

“I went to my doctor because I don’t feel well — I’ve got strep throat,” one myHIVteam member wrote.

“Acid reflux is driving me crazy, hurting my throat,” another member said.

It can be challenging to tell the difference between all the illnesses that cause a sore throat, which is why it’s crucial to seek advice from a healthcare provider for long-lasting or severe symptoms. According to the American Academy of Otolaryngology-Head and Neck Surgery, you should visit the doctor if you have any of the following:

• A severe sore throat lasting more than a week
• Trouble swallowing, breathing, or opening your mouth
• Joint pain
• Rash
• Earache
• Body temperature over 101 degrees Fahrenheit
• Bloody saliva or phlegm
• Recurrent sore throats
• Lump in the neck
• Hoarseness for more than two weeks
• Swelling of the face or neck

Any of these symptoms could indicate disease more severe than a common cold, such as a bacterial infection or acute HIV infection.

Getting Tested

Having undiagnosed — and therefore untreated — HIV allows the virus to continue replicating, causing more harm to the affected person and increasing the risk of the virus spreading to others. Research shows that starting antiretroviral treatment (ART) early in the course of HIV lowers the risk of AIDS and other serious health problems, so early HIV diagnosis is crucial.

Although other viruses more commonly cause sore throat than HIV does, people with sore throat or other symptoms of acute HIV should get tested. This advice is especially important for those who also have possible HIV exposure. Risk factors for HIV include:

• Having anal or vaginal sex without a condom or medicines to prevent or treat HIV with someone whose status is unknown or who has HIV that’s not controlled by their own ART
• Having multiple sexual partners since the last HIV test
• Sharing needles, syringes, or other drug injection devices
• Having a history of sex work
• Being diagnosed with or treated for another sexually transmitted infection
• Being diagnosed with or treated for hepatitis or tuberculosis

Cleveland Clinic recommends that people with any of the above risk factors be tested once a year. Given that many people with HIV have no symptoms, everyone between ages 13 and 64 should get tested at least once. People at older ages should be tested as well.

Several options exist for HIV testing. There’s no way to detect the virus just after infection. This is due to the window period — the time after a person is exposed to HIV but before a test can reliably detect it. The length of the window period depends on the type of test used. Testing too early may lead to a false-negative result. One test that should be considered for people suspected to have recent exposure or acute HIV symptoms is the nucleic acid test (NAT). NATs measure the amount of virus in the blood and can detect HIV as early as 10 to 33 days after exposure.

Antibody and antigen/antibody tests are also available. Antibodies are produced by the immune system in response to HIV, and antigens are parts of the virus that trigger the immune system. Antibody tests can detect HIV as early as 23 to 90 days after a person is infected, while antigen/antibody tests can detect the virus within 18 to 90 days after a person is infected, depending on if the testing is done in the lab or in the clinic (called “rapid testing”).

If you’re looking to get tested for HIV, talk with your doctor about which type is best for you and how regularly you should be tested. If you get an HIV test after a potential HIV exposure and the result is negative, get tested again after the window period for the type of test you took.

Educating Yourself

Because of significant historical and current stigma around HIV, getting tested may feel daunting. However, HIV and AIDS healthcare providers are committed to helping people feel comfortable and supported when seeking HIV-related care.

If someone you love has HIV or is concerned they may have HIV, it’s important to show your support for their health journey. HIV testing is quick, confidential, and free in some places. HIV treatment is also highly effective at helping people live longer.

Anyone looking to get tested or treated should feel comfortable doing so. Educating yourself about HIV can help reduce the stigma and support those living with HIV.

Find Your Team

On myHIVteam, the social network for people with HIV and their loved ones, members come together to ask questions, give advice, and share their stories with others who understand life with HIV.

Are you living with HIV or concerned that you may have acquired it? What early symptoms of HIV do you have? Share your experience in the comments below, or start a conversation by posting on your Activities page.