Much HIV prevention research ignores the underlying reasons why drug-using men who have sex with men (DU-MSM) use substances during sex. The present study explores DU-MSM descriptions of the relationships among substance use, sex, and risky sex practices. Twenty-seven in-depth qualitative interviews were conducted with sexually active DU-MSM. The research findings illustrate six roles of substances within the sexual lives of DU-MSM: Enhancing the sexual experience, increasing sexual arousal, facilitating sexual encounters, increasing the capacity for sexual behaviours, prolonging sexual experiences, and increasing the capacity to “turn a trick.” While acknowledging experiences of substance use leading to risky sex practices, participants expressed scepticism of any reductive causal relationship. The findings question recurrent assumptions that underpin HIV prevention initiatives and redirect research efforts in ways that may better inform HIV prevention.Read More: http://informahealthcare.com/doi/abs/10.1080/16066350310001640161?journalCode=art