HIV in Women: Symptoms You Shouldn’t Ignore

A silent storm was brewing. As a young, 30-year-old marketing executive in Mumbai, Meera* brushed off her fatigue, linking it to her hectic lifestyle. But as weeks turned into months, the symptoms intensified, accompanied by unexplained weight loss and recurrent infections.

As she sought answers, fear and confusion were Meera’s constant companions. It took an alarming decline in her health and an astute doctor to suspect HIV. The diagnosis hit her like a lightning bolt. Life, as she knew it, would never be the same. She was now forced to confront a disease shrouded in misconceptions and fear.

Meera's experience is not uncommon. Many face similar challenges in recognising the signs of HIV in women, due to their often subtle nature and overlap with other common symptoms. Stigma and limited awareness further contribute to delayed diagnosis and inadequate care.

HIV/AIDS in women: Understanding the impact and the virus

Women and girls remain disproportionately affected by the global HIV epidemic. In 2022, over 20 million women and girls were living with HIV — more than 50% of all diagnosed cases. Teenage girls face an even higher risk, with 98,000 new infections that year, more than double the rate for boys. Despite progress, challenges like stigma, discrimination, sexual violence, economic hardship, and limited healthcare access continue to worsen outcomes. Globally, 69% of women with HIV experience stigma, nearly one million children and adolescents remain untreated, and over half of those affected live in Eastern and Southern Africa.

India reflects similar trends, where stigma prevents many HIV-positive mothers from seeking care, affecting their children’s health. In 2021, nearly 5,000 children contracted HIV from their mothers, mostly during pregnancy, childbirth, or breastfeeding. Understanding how HIV manifests in women is crucial for early intervention and improved health outcomes.

HIV (human immunodeficiency virus) attacks the body’s immune system, specifically CD4 cells that help fight infections. When enough CD4 cells are damaged, HIV can progress to AIDS (Acquired Immunodeficiency Syndrome), the most advanced stage of the infection.

Can HIV symptoms in women be different from those in men?

“HIV can manifest differently in women than in men. Symptoms like pelvic inflammatory disease, menstrual irregularities, and increased susceptibility to other infections can be indicators. Early detection is crucial, not just for the woman's health but also to prevent transmission to her children,” says Dr Miloni Gadoya, a gynaecologist in Mumbai.

Early symptoms of HIV infection in women include:

1) Menstrual changes

How do gynaecological issues relate to HIV in women? Women who have HIV might go through changes in their menstrual cycle. Periods might become lighter, heavier, or irregular. Missed periods can occur, especially if there's rapid weight loss. Hormonal shifts can also worsen menstrual symptoms like cramps, breast tenderness, and fatigue.

2) Vaginal yeast infections

HIV weakens the immune system, making women more susceptible to vaginal yeast infections. These infections cause early symptoms of HIV infection in women like vaginal burning and itching, painful sex, painful urination, and thick, white discharge. Although yeast infections are common in women, they tend to be more frequent and severe in those with HIV due to a compromised immune system.

3) STDs

Women with HIV are at an increased risk of sexually transmitted diseases (STDs). In women with HIV, conditions such as genital herpes, pelvic inflammatory disease (PID), and bacterial vaginosis can be more prevalent, more severe, and harder to treat. Additionally, having both HIV and another STD can make it easier to spread HIV to sexual partners.

4) Cervical cancer

Women living with HIV are six times more likely to get cervical cancer compared to those without HIV. Most of the cervical cancer cases can be tied to the human papillomavirus (HPV). Fortunately, cervical cancer is largely preventable if the patient opts for regular screenings. Timely vaccination can also help prevent HPV infection in women with HIV.

How is HIV transmitted?

HIV is primarily spread through:

• Sexual contact: This includes vaginal, anal, and oral sex. Using condoms correctly every time reduces the risk of HIV transmission.
• Sharing needles or syringes: This practice is common among people who use illegal injectable drugs like heroin, methamphetamines, or cocaine.
• Mother to child: HIV can be transmitted from a mother to her child through three ways — during pregnancy, childbirth, or through breastfeeding if the mother is infected. However, effective prevention methods like antiretroviral treatment for the mother can significantly reduce this risk.
• Blood transfusion: While extremely rare in countries with advanced blood screening systems, there's a risk of HIV transmission through contaminated blood products. However, rigorous testing and screening procedures have made this risk minimal.

It should be emphasised that HIV is not spread through simple physical interactions like hugs or kisses, using the same utensils, or from mosquito bites.

How to prevent HIV from spreading?

HIV might not be a topic we bring up every day, but it’s one that deserves our attention. While the virus is serious, the good news is that it’s also highly preventable. With the right information and a few conscious decisions, we can significantly reduce the risk of transmission. Whether for yourself, a loved one, or your community, learning how to prevent the spread of HIV is a powerful step toward a healthier future. Here’s how you can prevent the virus from spreading.

• Practise safe sex: Always use a condom while having vaginal, anal or oral sex. Know your sexual partner’s medical history. Limit the number of sexual partners to avoid risks of HIV and other STIs.
• Get tested regularly: Get yourself checked regularly. Encourage your partner to get tested too.
• Medications: There are medications available that can reduce the risk of getting HIV by up to 99% when taken correctly. Talk to your doctor if you’re at higher risk (e.g., have multiple sexual partners, inject drugs, or have an HIV-positive partner). Ensure you take the medication as prescribed by a professional.
• Never share needles: Avoid sharing needles, syringes, or any injecting equipment, even razors. Use clean, sterile tools every time.
• Ensure safe blood transfusions: In healthcare settings, ensure that all blood products are screened for HIV. Donate and receive blood from licensed and certified facilities that run thorough tests, like NAT tests, to ensure blood safety.

Can HIV symptoms in women be different from those in men?

HIV can manifest differently in women than in men. According to Dr Miloni Gadoya, gynaecological issues, menstrual irregularities, and frequent infections can be early indicators. Early detection is vital for the woman’s health and to prevent transmission to children.

Key signs and considerations for women with HIV:

• Menstrual changes: Periods may become irregular, lighter, heavier, or missed. Hormonal shifts can worsen cramps, breast tenderness, and fatigue.
• Frequent infections: Increased risk of vaginal yeast infections and other STDs, which can be more severe and harder to treat.
• Cervical cancer risk: Women with HIV are six times more likely to develop cervical cancer, often linked to HPV. Regular screenings and vaccination help prevent.
• Ageing and bone health: Menopause may occur earlier, with a higher risk of osteoporosis; some HIV medications can reduce bone density.
• Heart disease: Women with HIV have a higher risk of cardiovascular issues.
• Pregnancy & infant care: With proper treatment, healthy pregnancies are possible, and mother-to-child transmission can be reduced to under 1%. Feeding choices should consider risks and benefits.
• Medication effects: Some treatments may reduce the effectiveness of hormonal methods and cause side effects like nausea or fat accumulation, which can be more common in women.

Here’s what to do if you suspect you have HIV in women

1) Testing and diagnosis

The only way to know for sure if you have HIV is to get tested. There’s no need to wait for symptoms, as many people with HIV don't experience any early signs. There are various diagnostic tests that your doctor may recommend.

HIV testing is available at several locations, including:

• Hospital or stand-alone laboratories
• Clinics
• Blood donation centres

2) Seeking medical help

The first question many people ask is: What happens if I am HIV positive? If you suspect that you have HIV, it's crucial to seek medical attention immediately. A healthcare provider can:

• Confirm your HIV status through testing
• Provide information about HIV, treatment options, and prevention
• Offer emotional support and counselling
• Connect you with resources and support groups

Empowering women living with HIV

Living with HIV comes with unique challenges, from early symptoms to long-term health considerations. Yet with proper care, support, and modern treatments, women with HIV can lead full and fulfilling lives. Breaking the stigma around HIV is crucial by encouraging open conversations, spreading awareness, and providing comprehensive support. We can build a society where women living with HIV feel empowered, respected, and valued.

Frequently Asked Questions

1. Can HIV symptoms in women differ from those in men?

Yes. Women may experience gynaecological symptoms such as menstrual irregularities, pelvic inflammatory disease, or frequent yeast infections, which can indicate early HIV infection.

2. What are the early signs of HIV in women?

Early signs include changes in menstrual cycles, frequent infections, unexplained fatigue, weight loss, and recurrent yeast or urinary tract infections.

3. How does HIV affect pregnancy in women?

With proper treatment and care, women with HIV can have healthy pregnancies. Regular medical guidance significantly reduces the risk of mother-to-child transmission. It’s essential to consult your doctor to ensure the best possible outcome for both mother and child.

4. Are women with HIV at higher risk for other health issues?

Yes. Women with HIV are more susceptible to cervical cancer, osteoporosis, cardiovascular disease, and earlier onset of menopause.

5. How can women protect themselves and manage HIV effectively?

Regular medical check-ups, adherence to HIV medications, practising safe sex, and maintaining a healthy lifestyle are key to managing HIV and preventing complications.