Genital Herpes Simplex Virus (HSV) is a major global public health issue where the number of patientsincreases every year. It has a variety of clinical presentations, and a tendency to recur when the immunesystem is compromised. Patients with human immunodeficiency virus (HIV) have a higher chance ofbeing infected with HSV possibly due to their high risk attributes. We reported a case of a 19-yearoldhomosexual male who was recently diagnosed with HIV and presented with perianal lesions for aduration of three months. This case is presented with the aim to highlight the differential diagnosis ofrash in immunocompromised patients and how to approach them.