Flu and People with HIV

Content From: HIV.govUpdated: July 11, 20236 min read


This page has content that may be inconsistent with new CDC Respiratory Virus Guidance. The content of this page will be updated soon.
 If you have HIV or AIDS, take care of yourself. Get a flu shot.

Are People with HIV at High Risk for Serious Flu Illness?

Yes. People with HIV or AIDS are at high risk of developing serious complications from the flu, so it’s important to lower your chances of getting sick from the flu and seek care if you think you have it. This is especially true for people with HIV who have a very low CD4 cell count or who are not taking medicine to treat HIV (called antiretroviral therapy or ART).

Other groups at high risk of serious flu complications include people with other chronic health conditions, pregnant people, and adults age 65 and older.

What Is the Flu?

The flu is caused by a virus. Common symptoms of the flu include:

  • Fever and chills
  • Cough
  • Sore throat
  • Runny or stuffy nose
  • Muscle or body aches
  • Headache
  • Fatigue

Some people with the flu may throw up or have diarrhea (watery poop)—this is more common in children than adults. It’s also important to know that not everyone with the flu will have a fever.

The flu is worse than the common cold. It’s a common cause of problems like sinus or ear infections. It can also cause serious complications.

The flu is contagious, meaning it can spread from person to person. The flu can spread when:

  • Someone with the flu coughs, sneezes, or talks—and droplets from their mouth or nose get into the mouths or noses of people nearby.
  • Someone touches a surface that has flu virus on it and then touches their mouth, nose, or eyes.

People can spread the flu before they know they’re sick—and while they have the flu. Learn more.

What Is the Best Way to Prevent Flu?

Getting a flu vaccine is the best way to safely and effectively protect yourself and your loved ones against the flu.

There are many benefits to the vaccine. If you are vaccinated, you are less likely to get the flu. And, if you do get sick, your illness will likely be milder, which helps keep you out of the hospital. The vaccine also reduces your chances of dying from the flu and reduces the risk of some cardiac events among people with heart disease. Flu vaccination during pregnancy helps protect pregnant people from flu during and after pregnancy and helps protect their infants from flu in their first few months of life.

People with HIV should get a flu vaccine every year, if possible, by the end of October or before flu starts spreading in their community.

People with HIV should receive the flu shot rather than the nasal spray. The flu vaccine is available as a shot and a nasal spray. The shot does not contain live flu virus whereas the nasal spray contains flu virus that is alive but weakened. People with weakened immune systems may have a higher risk of complications from the nasal spray.

You cannot get the flu from the flu vaccine. You should tell your provider if you are allergic to eggs (since some vaccines are made with flu virus that is grown in eggs) or if you have had a bad reaction to other vaccines in the past.

Getting vaccinated is easy. Vaccines are available at the doctor’s office, health centers and clinics, and many pharmacies—and most are covered by insurance.

Visit hhs.gov/immunizations for more information about the flu vaccine and different ways to pay for vaccines.

Use the Flu Vaccine Finder to find a flu vaccine in your area.  

What Other Actions Can You Take to Prevent Getting or Spreading the Flu?

In addition to getting a flu shot every year, people with HIV should take the same actions CDC recommends for everyone:

  • Avoid close contact with people who are sick.
  • Stay home when you are sick.
  • Cover your mouth and nose.
  • Clean your hands.
  • Avoid touching your eyes, nose, and mouth.
  • Practice other good health habits.

Encourage people you frequently spend time with to get a flu vaccine to protect both of you.

If you do get sick with the flu, prescription medications may help. These medications work best when started early, one to two days after flu symptoms begin.

CDC recommends that people at high risk for serious flu complications such as people with HIV—especially those with low CD4 cell counts or not on ART—should get antiviral drugs as early as possible, because these drugs work best when started early (within 48 hours after symptoms start).

What Should You Do if You Think You Have the Flu?

If you get sick with flu symptoms call your doctor right away.

People experiencing difficulty breathing, shortness of breath, and other emergency warning signs should seek medical care right away.

Until you know if you have the flu, stay away from others as much as possible or wear a face mask, if you have one. Follow common preventive actions such as washing hands and covering coughs.

If you get a flu diagnosis, stay at home for at least 4-5 days after onset of symptoms. People with the flu are most contagious during the first 3 days of illness.

Flu Symptoms vs. Early HIV Infection

Early HIV is the beginning stage of HIV, right after someone gets the virus. It is also called acute HIV. Within 2 to 4 weeks after infection with HIV, about two-thirds of people will have a flu-like illness. This is the body’s natural response to HIV infection. If you are not sure if you have the flu or early HIV, ask yourself if you may have been exposed to HIV (such as by having vaginal or anal sex without a condom or medicine to prevent or treat HIV, or by sharing injection drug equipment) within the past few weeks. If so, talk to a healthcare provider. Certain HIV tests available in healthcare settings can detect HIV as early as 10 days after an exposure took place. By talking with a health care provider about your symptoms and your recent possible exposure to HIV, he or she can make sure you get the proper tests to detect early HIV. Use the HIV.gov Locator to find a provider or HIV testing site near you.

Flu and COVID-19

You can have flu and COVID-19 at the same time. Health experts are still studying how common this can be. You cannot tell the difference between flu and COVID-19 by the symptoms alone because they have some of the same signs and symptoms.  Specific testing is needed to tell what the illness is and to confirm a diagnosis. Learn more.

According to CDC, you can get a flu vaccine and a COVID-19 vaccine at the same visit if you are due for both vaccines. You can get both vaccines in one arm or a vaccine in each arm, if you want. Learn more.

Remember, getting vaccinated is the best way you can protect yourself against both the flu and COVID-19.