HIV conversion sickness?

Originally Published: February 16, 1996 - Last Updated / Reviewed On: April 2, 2010
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(1)
Alice,

I've heard about conversion sickness and being HIV+ could you tell me more about the symptoms and what exactly it is?

—Unenlightened

(2)
Dear Alice,

I have had an unsafe sexual encounter, receiving oral sex without wearing a condom. Three days after this, I noticed a slight itching on the tip of my penis, and three weeks later I started to feel a slight aching in my lower joints, in the thigh and leg muscles. This aching varied in location. I took an HIV antibody test, which was negative, 9 weeks after having sex. Some weeks later on, I began to feel a little aching in my arms and other joints, as well, and I developed a fever and very swollen lymph glands in the throat. This lasted for about one-and-a-half weeks.

I went to a doctor and they took some blood tests, I don't know what, but the doctor said that it was a bacterial infection and I was given antibiotics. The fever and swollen glands ceased, but I still have aching muscles and joints, which has been going on for 7 weeks after the fever. The aching is light, and varies in location from my underarms, overarms, legs, and thighs. Are these signs of HIV conversion sickness and do HIV antibodies only develop after the fever symptoms and not before this?

—Worried

Dear Unenlightened and Worried,

HIV diagnosis and treatment continue to improve, but HIV/AIDS remains a complex condition. You two are certainly not alone in your concerns and questions about HIV infection and early symptoms. So-called conversion sickness, the body's first reaction to the presence of the HIV virus, is often a first sign of HIV infection, but antibody testing is still the most reliable way to diagnose HIV.

HIV is passed through body fluids including blood, semen, and vaginal fluid. It is possible to contract HIV while receiving oral sex without a condom, but the risk is very low. In fact, there's a higher chance of getting other sexually transmitted infections (STIs) like chlamydia or gonorrhea from unprotected oral sex. After unsafe sex or a possible exposure to HIV, fast treatment can greatly reduce the chance of infection. Dubbed post-exposure prophylaxis or PEP, the treatment consists of a four-week regimen of antiretroviral medication.

After contracting HIV, the immune system begins to produce antibodies to the virus. This process, called seroconversion, can last a few weeks to six months. About two to four weeks after being infected, some people experience a flu-like illness called conversion sickness or primary/acute HIV infection. Symptoms last up to two weeks and may include:

  • Fever
  • Headache
  • Sore throat
  • Swollen lymph glands
  • Rash
    List adapted from the article HIV/AIDS Symptoms from the Mayo Clinic.

Conversion sickness can be tough to spot since it often resembles the flu, a common cold, stress, mono, or other STIs. Like the flu, not everyone has the same symptoms, and not everyone who contracts HIV will experience conversion sickness. Worried, that means it's tough to say if your achiness and swollen glands are HIV-related.

The surest way to confirm or rule out HIV infection is to get tested. After someone is infected with HIV, there is a "window period" of a few weeks to six months (the same time frame as seroconversion) when an HIV test is not accurate. During this time, the person who is newly infected with HIV begins to form antibodies to the virus. HIV tests actually look for antibodies, not the virus itself, so test results come up positive only after a person has seroconverted and antibodies can be detected. It's possible to get a "false negative" result at nine weeks; re-testing at three months can help you to be sure that you are HIV-free. A three-month test is very reliable since seroconversion is well under-way by that point, but folks who are still concerned can double-check the results with a six-month test. Practicing safer sex in the meantime will help ensure that any test results are reliable.

Worried, it sounds like you are unsure about the diagnosis from your health care provider. If so, you may want to go back her/him and ask what type of bacterial infection or STI you had. A return visit will also give you the opportunity to discuss your lingering aches and pains.

If you have any other questions or concerns about HIV or AIDS, talk with a health care provider. Students at Columbia can make an appointment at Primary Care Medical Services (PCMS) by calling x4-2284 or by logging on to Open Communicator. Columbia students can also talk with a peer counselor from the Gay Health Advocacy Project (GHAP). For more general information about HIV and other STIs, including transmission risk and prevention strategies, visit:

Centers for Disease Control and Prevention (CDC)

The Body: The Complete HIV/AIDS Resource

Gay Men's Health Crisis (GMHC)

From day one, HIV infection looks different from person to person, so it's dicey to determine HIV infection based solely on symptoms. For the most reliable results and peace of mind, an HIV antibody test three months after exposure is still the best way to be sure about your status. 

Alice