A standardized interview designed by the Centers for Disease Control was used to collect data on demographics and risk behaviors. Qualitative information was obtained from 13 open- ended questions about social environment and psychosocial history embedded within the standard quantitative questionnaire. Youths reported high lifetime rates of injection drug use (45 percent), recent drug and alcohol use (100 percent), and current homelessness (84 percent). Injection drug-using youths were more likely than noninjection drug-using youths to report traumatic psychosocial histories, including parental substance use and forced institutionalization, use of alcohol and other noninjection drugs, a history of survival sex, and the use of squats or abandoned buildings as shelter. These findings underscore the need for multifaceted service and prevention programs to address the varied needs of these high-risk youths. 4 tables and 48 references