Advances in the management of HIV infection have resulted in significant changes in survival and in the prevalence and incidence of oral diseases found in persons infected with HIV (as discussed in other articles in this series). HIV is associated with an increased risk of malignant disease that is related to immunosuppression and the activity of the HIV transactivator of transcription protein, coviral infection and exposure to carcinogens. The presence of oral malignancies varies with the route of the transmission of HIV and varies geographically, based on behaviour, viral cofactors, HIV therapy and genetic variation. Oral health care providers can identify these lesions early.