How Is HIV Different in Men? Transmission, Symptoms, and Testing

HIV, or human immunodeficiency virus, is a virus that attacks certain cells in your immune system. HIV is a retrovirus, meaning it’s a type of virus that takes over a cell by using its own set of instructions to change how the cell works. The virus then makes copies of itself and weakens the immune system in the process.

Symptoms typically start a few weeks after initial infection (more below). These initial symptoms often look and feel like the flu. HIV can affect both men and women, but men may have some different symptoms. We’ll explain below. 

How common is HIV in men?

Nearly 40 million people around the globe, including 1.2 million people in the U.S., are living with HIV. 

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In 2022, there were about 31,000 new cases of HIV in the U.S. Both men and women make up new HIV cases. But men accounted for the majority of these new cases (81%). Most new HIV infections — 7 in 10 cases — are in men who have sexual intercourse with other men.

Some groups and areas are disproportionately affected. Black and Hispanic men who have sex with other men made up over 70% of new cases in 2022. States in the Southern U.S. have higher rates of new HIV diagnosis than other areas of the country.

What are the symptoms of HIV in men?

There are three stages of HIV infection: 

1. Acute infection

2. Chronic infection

3. Advanced HIV (formerly referred to as AIDS)

Each stage has its own set of symptoms.

Acute infection (early symptoms)

Around 70% of newly infected people get sick with flu-like symptoms. These can last a few days or a few weeks. Symptoms of this stage include:

• Fever and/or chills

• Sore throat

• Fatigue

• Rash

• Night sweats

• Muscle aches

• Swollen lymph nodes

• Ulcers in the mouth

• Diarrhea

Chronic infection (asymptomatic or no symptoms)

After the early-stage symptoms go away, people with HIV go into a period called the chronic HIV infection stage. In this stage, they may not have any symptoms for many years. This is because the virus is multiplying at lower rates. 

For people who aren’t receiving treatment for HIV, the virus will likely weaken the immune system over time and progress to advanced HIV, the third and final stage.

Advanced HIV (late symptoms)

The last stage of HIV infection was formerly referred to as AIDS (acquired immunodeficiency syndrome). Symptoms can include:

• Weight loss

• Fever

• Night sweats

• Diarrhea

• Persistent fatigue

• Swollen lymph nodes in the armpits, neck, or groin area

• Sores on the mouth, genitals, or anal regions

• Frequent infections

• Skin changes and rashes

• Problems with memory or depression

Are any HIV symptoms specific to men?

Not really. Men and women usually have similar symptoms of HIV. It’s common for men to have concerns about being sexually active following HIV diagnosis. Some potential conditions that can occur in men after an HIV diagnosis include:

• Low sex drive 

• Erectile dysfunction (ED)

• Ejaculation disorders, including premature ejaculation

How is HIV transmitted to men?

Transmission of HIV happens in similar ways for both men and women. The more virus someone has (called viral load), the more likely they are to transmit HIV to another person. So, someone in the early stage and/or without treatment has a higher chance of transmitting the virus to someone else. 

HIV is transmitted through bodily fluids. These include:

• Semen

• Vaginal fluids

• Rectal fluids

• Breastmilk

• Blood 

This is why the following are sources of infection:

• Sexual activities

• Sharing injection materials like needles and syringes

• Using non-sterile needles for piercings or tattoos

• Accidental needlesticks

• Childbirth

How do you get tested for HIV?

There are three types of tests for HIV. Most are blood tests completed by a laboratory. But some tests (like rapid tests) use saliva or blood from a finger prick. Here’s an overview of the tests:

• Antibody testing looks for antibodies that fight HIV in the body. Antibodies are proteins the immune system makes in response to a foreign substance. These tests require blood or oral fluid samples. Lab results for an antibody test usually take a few weeks to a few months. But there’s a rapid test option that takes about 30 minutes for results.

• Antigen/antibody testing is a blood test that detects both the virus and antibodies. Test results are typically ready in 18 to 45 days. Rapid testing can give results in about 30 minutes.

• Nucleic acid testing is a blood test that looks for the virus only and tells you how much of the virus is present. This test is common for someone recently exposed to HIV. It may also be used on someone who shows early symptoms of the virus and has tested negative with other tests. This test can detect HIV sooner than the other tests. But test results are usually ready in 10 to 33 days.

Self-testing is an option if you want to know your results in private. This is an antibody test you can perform at home using a sample of fluid from your mouth. Results are typically available within 20 minutes. It’s important to follow the instructions carefully on self-tests for better accuracy of results.

The CDC recommends testing at least once for anyone age 13 to 64 years. But there are certain factors that may increase your risk of becoming infected with HIV. So you may consider testing for HIV more frequently if:

• You’re engaging in sexual activities with someone who has HIV.

• You’re a man having sexual intercourse with another man.

• You’ve had more than one sex partner since your last HIV test.

• You inject drugs into your body or use needles that aren’t sterile

• You have another sexually transmitted infection (STI), hepatitis, or tuberculosis 

If you’re engaged in any of these activities, talk to a healthcare professional about how often to get tested. They may also suggest pre-exposure prophylaxis (PrEP) medication and other options to reduce your risk of becoming infected. 

Once a person becomes infected and the virus multiplies, it stays with them for life. But it’s a myth that HIV diagnosis is a death sentence. Someone who’s taking HIV treatment can live as long as people who don’t have the virus.

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Written by:

Alexandria Nyembwe, PhD, MBA, RN

Alexandria Nyembwe has been a registered nurse since 2017. She has a background in cardiac care and has clinic experience as a nurse, serving people experiencing housing instability.

Edited by:

Katie E. Golden, MD

Katie E. Golden, MD, is a board-certified emergency medicine physician and a medical editor at GoodRx.

Reviewed by:

Mandy Armitage, MD

Mandy Armitage, MD, has combined her interests in clinical medicine with her passion for education and content development for many years. She served as medical director for the health technology companies HealthLoop (now Get Well) and Doximity.

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