HIV-1 infection among IVDUs is increasing at a rapid rate in the U.S. Because many Emergency Departments experience many visits from patients with this risk factor, the impact on emergency services can be considerable. Because many of these patients currently have asymptomatic infection, knowledge of clinical presentations of HIV-1 infection is valuable, as the Emergency Department may be the site for the initial presentation of complications related to HIV-1. Finally, Emergency Departments may play a vital role in preventing further progression of this deadly and destructive disease among this risk group.