Body Aches and STDs: Which Infections Cause Myalgias?

Body aches (myalgias) can occur with several sexually transmitted infections, typically during acute or disseminated phases.

STDs Associated with Body Aches

• HIV (acute retroviral syndrome): Fever, rash, lymphadenopathy, myalgias, arthralgias 2–4 weeks post-exposure.
• Syphilis (secondary): Diffuse rash, fever, malaise, myalgias, headache 4–10 weeks after chancre.
• Gonorrhea (disseminated gonococcal infection - DGI): Migratory arthralgias, tenosynovitis, dermatitis, fever; myalgias common.
• Chlamydia (LGV, reactive arthritis): Can trigger reactive arthritis (Reiter’s) with joint pain, myalgias, conjunctivitis, urethritis.
• Hepatitis B/C (acute): Serum sickness-like prodrome: fever, rash, arthralgias, myalgias before jaundice.
• Hepatitis A: Food/water-borne; not primarily sexual but can be transmitted sexually (MSM); causes myalgias, fatigue, nausea.

Differential Diagnosis

Myalgias are nonspecific: viral syndromes (influenza, EBV, COVID-19), autoimmune, fibromyalgia, statins, electrolyte imbalance. STD testing (NAAT, serology) indicated if exposure risk.

Action

If persistent myalgias with potential exposure, seek testing. Early treatment prevents complications and transmission.