From 1999 to 2001, 683 out-of-treatment, African-American crack-using women, 219 of whom were homeless, were interviewed and serologically tested. Risk factors that were measured for the women included adverse childhood experiences, psychological distress, physical health, violence and victimization, drug use, and risky sexual behaviors. Protective factors measured were marital status, education, public assistance, and the responsibility of caring for children. Both groups of women began using crack in their mid-twenties and started their drug use with alcohol consumption when they were teens. Logistic regression analysis found that variables associated with being homeless were physical abuse before the age of 18, crack "runs" greater than 24 hours, income less than $500 in the last 30 days, depression, and current cigarette smoking. Protective factors identified were marital status, living with children under age 18, having had a physical exam in the past year, and receiving welfare money in the last 30 days. Being sexually assaulted within the past 90 days was marginally associated with homelessness in the model. Interventions for these women must take into account cultural, contextual, and gender issues and incorporate risk reduction related to violence, alcohol use, and comorbid conditions. Intervention must also address housing issues, education, and skills necessary for independent living. 7 tables, 48 references, and appended annotated listing of selected cross-sectional studies of African-American women who use crack