Fifteen years into the HIV/AIDS epidemic, a great deal is now known about the different populations impacted by the disease, including those affected directly or indirectly by drug use. Anthropology has prayed a critical role in assisting with this task by identifying hidden populations, developing new methodological approaches, and targeting outreach efforts. In spire of this considerable body of ethnographic knowledge, men who have sex with other men (i.e., MSM, or gay and bisexual men) who use drugs have not received the same research attention as other drug users, despite the fact that they represent nearly one-fifth of AIDS cases in the U.S. with injection drug histories. In response to the alarming increase in HN seroprevalence among this population, this ethnographic project provides preliminary data about those who are at dual risk for HN through both homosexual behavior and injection drug use.