Does HIV Make Your Vagina Smell? - TheBody.com

Question

About two months ago, I had unprotected sex with a man who I later found out was living with HIV. I'm going to go get tested next week. Right after we had sex, my vagina smelled very fishy. This lasted for about four days and just stopped. I was wondering, could that have anything to do with HIV?

Answer

There are a lot of misconceptions about the way HIV works. That misunderstanding can lead to stigma and discrimination, which is why understanding the facts about HIV is so important. "For those living with HIV, the stigma has a bigger impact than the [biological] reality," says Daniel Saynt, founder of the New Society for Wellness (NSFW).

If you're asking whether HIV can cause a person's vagina to smell, then you might also have a few other basic questions about HIV, like: How is it transmitted? How can I know if I have it? What is the first sign of HIV infection? Here is a quick breakdown, because it's important to know the basics before we delve further into the question of vaginal/semen/genital odor and sexually transmitted infections (STIs).

After HIV enters the bloodstream, it uses its spiky exterior to cling on to a certain type of white blood cells known as T cells or CD4 cells. These are a key part of your body's defense against infections. Once HIV climbs into a CD4 cell, it uses the cell's own biological machinery to create copies of itself, which tricks the immune system into ignoring the virus. Once there are enough copies, HIV begins to lower the number of CD4 cells in a person's body and weaken their immune system.

A weakened immune system means that people living with untreated HIV may begin to develop health problems over time. (HIV treatment can prevent this from happening.) If you don't have an immune system that is capable of fighting off infections, you eventually get sick. This risk tends to slowly increase over the course of years, unless a person begins taking HIV medications.

When a person is first infected with HIV, they may not have any symptoms at all. If they do, one of the first symptoms of HIV is often a fever, followed with swollen lymph nodes and other flu-like symptoms. It's almost impossible to tell HIV apart from any other cold- or flu-like infection—which is why getting tested for HIV is so important.

This information is important in the context of this question because a person living with HIV who is not on effective treatment can be more likely to contract other STIs and genital infections. And some of those other infections can change the way your vagina, vulva, penis, semen, etc. smell. Let's break it all down.

HIV and Vaginal Odor: What's the Connection?

Firstly, let's get something straight: Vaginas and vulvas have a smell. They are a part of the human body, and they are not supposed to smell like flowers or lavender or whatever the heck "hygiene" companies try to play up. A slight vaginal odor is normal. Vaginal odor often varies throughout a vulva-owner's menstrual cycle.

There are several vaginal infections that can lead to an unpleasant smell, but HIV is not one of them.

Bacerial Vaginosis (BV)

A fishy odor, in particular, is usually due to bacterial vaginosis (BV). Vulva-owners and "women [who] are HIV positive are more likely to develop BV, which leads to vaginal discharge (gray or white) with a strong fishy smell," explains Daniel Boyer, M.D., a specialist in internal medicine, gynecology, and obstetrics.

Can BV Turn Into HIV?

To be clear: Can BV turn into HIV? Definitely not. Only HIV can turn into HIV. BV is a bacterial infection, and it can be cleared up with a round of antibiotics. BV is also one of the most common vaginal infections around: It's very important to keep in mind that nearly one in three women will get bacterial vaginosis at some point in their adult life. It can be spread through sex, but not always. If you have a weakened immune system, you're more likely to get BV from a sexual encounter than if you don't have a weakened immune system.

Other Causes of Vaginal Odor

Another infection that may cause a person to experience a change in odor is a yeast infection. Nearly 75% of women and vulva-owners will get a yeast infection at some point in their lives. This happens when there is an overgrowth of yeast, disrupting the vaginal flora. Yeast infections are usually characterized by a thick, white discharge and a sweet smell, and they can be spread between sexual partners.

As for STIs, there's only one that is known to result in odor in some cases: Trich. "Trichomoniasis is known to create a foul, fishy odor in some [vulva-owners and] women's vaginal fluids," explains Felice Gersh, M.D., OB/GYN, founder of the Integrative Medical Group of Irvine and author of Menopause: 50 Things You Need to Know.

If you notice a change in your normal vaginal discharge, whether in appearance or smell, it's best to call your doctor right away for advice and possible testing.

HIV and Semen Odor

Similar health issues to those that happen in vaginas/vulvas can also happen with penis-owners. "HIV may cause several health complications during its advanced stages if managed improperly, including bacterial infection and other germs that change the way semen smells," Boyer explains. These bacterial infections can become more serious if you are living with HIV and have a low CD4 count, as your immune system is compromised.

This applies to the smell of the penis and penile discharge. HIV alone will not impact the smell of the penis, but because HIV attacks the immune system, it can put people living with HIV at higher risk of contracting other STIs like trichomoniasis that can affect smell. HIV isn't the direct culprit.

If you notice a change in the smell of your semen, experience pain when you pee, or have a strange discharge, contact your doctor immediately, as the condition can become more serious if left untreated.

How Can You Prevent STIs That May Cause Vaginal Odor?

The best way to avoid STIs is to have sex using barrier methods. "When rubber latex condoms (polyurethane male condoms or polyurethane internal condoms) are used correctly and consistently, they are 90% to 95% effective in preventing HIV transmission," explains Taylor Sparks, an erotic educator and founder of Organic Loven.

Additionally, getting tested for HIV and other STIs on a regular basis is a surefire way to know your status. It's important to protect both your own sexual health and that of your partners.

So, can HIV make your vagina or semen smell? No, but living with untreated HIV can lead to other infections that can. Simple enough, yes?

The stigma around HIV must end, and correct information must reign. As Saynt puts it, "HIV is no longer a death sentence, and sex with those who have HIV shouldn't be feared or stigmatized."