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Togliatti City is witness to a large epidemic of human immunodeficiency virus (HIV) associated with injecting drug use (IDU).This study sought to examine whether risk behaviors and risk factors associated with HIV differed across a sample IDUs by gender and sex work.A sample of IDU (n = 423) comprising female sex workers (SWs) (n = 66), non–sex workers (nonSWs) (n = 89) and men (n = 268) were recruited by field workers in community settings. Behavioral and HIV prevalence data were collected.HIV prevalence did not differ across the groups (∼56%), but gender adversely affected some risk factors. A comparison of risk behaviors indicated that SWs were more likely to engage in risky injecting behaviors than either men or nonSWs. They were also more likely to report a history of sexually transmitted infections.IDUs involved in sex work and IDU nonSWs require specific and targeted interventions to facilitate safer injecting and sexual behaviors.