Human papillomavirus (HPV) infections of the anogenital tract and HPV-associated anogenital neoplasia are commonly found in HIV-positive men and women. Although there is little evidence suggesting that the incidence of invasive cervical cancer is increased in HIV-positive women, the incidence of invasive anal cancer may be increased in HIV-positive men. Among HIV-positive women, cervical intraepithelial neoplasia progresses more rapidly and recurs more often after primary therapy than in HIV-negative women. HPV infection and HPV-associated disease are often multifocal in HIV-positive women, and they may be found in both the vulva and the anus. Cervical cytology appears to be adequate as a screening tool for cervical intraepithelial neoplasia in HIV-positive women, but the high recurrence rate and multifocal nature of this disease reinforces the need for careful evaluation and follow-up of the entire anogenital tract in these women.