This study investigated the prevalence of drug use and the drug use behavior among people living with HIV in Hong Kong. In this cross-sectional survey, subjects were recruited by convenience sampling from the out-patient clinic of a HIV treatment center. A total of 500 subjects completed the questionnaire between January and May 2017. About one third (31.4%, n=157) participants reported drug use behavior. Common substances used included methamphetamine (65%), rush poppers (59.2%), gamma-hydroxybutyrate (56.7%), ketamine (49%), ecstasy (45.9%), cannabis (34.4%), cocaine (18.5%), cough medicine (15.3%), and heroin (7%). Polydrug use was common (51%). Younger age, men who have sex with men, history of sexually transmitted infections, and smoking were independently associated with drug use. About 34.4% drug users had co-existing mental illnesses. Most drug users (91.1%) had never received any form of drug treatment services. Linking HIV-infected drug users to drug addiction treatment services is needed.