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Attendees presenting for treatment of acute illness at primary health care facilities in South Africa were assessed to determine the prevalence of human immunodeficiency virus (HIV) infection and the predictability of group I oral lesions (GOLs) for HIV infection.This was a cross-sectional analytical study. Patients >18 years of age were recruited and underwent an oral examination and a HIV test.A total of 522 attendees were examined and the HIV prevalence was 40%. None of them were taking antiretroviral drugs. GOLs were diagnosed in 53% of HIV patients, with pseudomembranous and erythematous candidiasis being the most common (38% and 24%, respectively). The average odds and likelihood ratios for multiple lesions were high (32 and 30, respectively) and showed a strong correlation between GOLs and a positive HIV status.The prevalence of HIV (40%) and GOLs (53%) was high. GOLs were useful markers of HIV infection, with multiple lesions being highly predictive of HIV infection.