The stromal-derived factor-1 (SDF-1) chemokine gene encodes the only natural ligand for CXCR4, the coreceptor for the pathogenic X4 HIV-1 strains. A single-nucleotide polymorphism (SNP) in the 3 0 untranslated region (SDF1-3 0 A ¼ rs1801157) of SDF-1 was reported to be protective against infection and progression in some, but not other, epidemiological studies. To identify additional alleles that may influence HIV-1 infection and progression to AIDS, nine SNPs (including rs1801157) spanning 20.2 kb in and around the SDF-1 gene were genotyped in over 3000 African American (AA) and European American (EA) participants enrolled in five longitudinal HIV-1/AIDS natural cohort studies. Six or five haplotypes were present at frequencies greater than 5% in AA or EA, respectively. Six of the nine SNPs occur on only one common haplotype (45%), while the remaining three SNPs were found on multiple haplotypes, suggesting a complex history of recombination. Among EA, rs754618 was associated with an increased risk of infection (OR ¼ 1.50, P ¼ 0.03), while rs1801157 ( ¼ SDF1-3 0 A) was associated with protection against infection (OR ¼ 0.63, P ¼ 0.01). In the MACS cohort, rs1801157 was associated with AIDS-87 (RH ¼ 0.31, P ¼ 0.02) and with death (RH ¼ 0.18, P ¼ 0.02). Significant associations to a single disease outcome were found for two SNPs and one haplotype in AA.