The authors compared male and female substance abusers and found that female substance abusers were at increased risk for HIV, relative to males, through sex‐risk behaviors. Specifically, women were more likely to have had sexual relations with a drug injector and greater involvement in prostitution, including exchanging sex for drugs or money, than men. Women had fewer legitimate employment opportunities and were less likely to have received support through illegal sources, excluding prostitution, than men. Women bad significantly lower perceived self‐concept, greater depression, and more anxiety than men. Gender, economic means of support, and self‐concept were highly interrelated. These findings underscore the need for interventions that address the economically marginalized position of addicted women and their low self‐concept.