This study examined sexual and drug use behavior in 247 methadone main
tenance patients, to explore the association of cocaine use with human
immunodeficiency virus (HIV) risk behavior. In univariate analyses, c
ocaine use was positively associated with any drug injection, number o
f injections, and sexual intercourse without condoms. These relationsh
ips remained significant after controlling for other drug use and demo
graphic factors. Heroin use also contributed to injection-related risk
. We conclude that cocaine use represents a continued source of risk f
or exposure to HIV in this population, and that more aggressive effort
s are warranted to reduce illicit drug use, particularly of heroin and
cocaine, in methadone patients.