AbstractThis study examines a population of inner-city crack cocaine users in Miami, Florida. Many study participants were also injection drug users; others were the sexual partners of injection drug users. In general, the self-reported health status of the study population was good, but men perceived their health in a more positive light than did women. HIV-seronegative men were most likely to report excellent or good health, and seropositive women reported the greatest incidence of poor health, regardless of the amount of crack use. Serostatus was statistically significant for women but not for men. Pneumonia was reported more frequently by women, while hepatitis and tuberculosis were reported more frequently by men. There was a significant gender difference in reported endocarditis among light users of crack, with more women that men reporting a history of endocarditis. Among sexually transmitted diseases, men reported more gonorrhea and women reported more syphilis. These gender differences were statistically significant only for heavy users of crack. A gender difference was evident in the HIV seropositivity rates, with 25.7% of men and 32.2% of women testing positive for antibodies to HlV. While this difference held true when frequency of crack use was controlled, the difference was not statistically significant. Women were significantly more likely than men to trade sex for drugs and/or money. Women who were heavy crack users traded most often and would be expected to be at correspondingly increased risk for HIV infection or transmission.