There are a number of differences in the clinical presentation and management of genital herpes in HIV-infected individuals compared to those not infected with HIV disease. The frequency and severity of genital herpes may be greater and disseminated disease is seen more frequently. Few studies have been designed specifically to establish the effectiveness of the currently available therapies for HIV-positive patients co-infected with genital herpes. Most agents appear to be effective in the treatment of immunocompromised patients, although higher doses may have to be used for longer and drug resistance occurs more commonly. There is emerging evidence that recurrent genital herpes has a significant effect on increased transmission of HIV disease.