Crystal methamphetamine is an extremely addictive stimulant that increases sexual arousal while reducing inhibition and judgment. Its use is associated with a range of high-risk sexual behaviors that increase the likelihood of acquiring or transmitting HIV. Given the relatively high prevalence of crystal methamphetamine use among people living with HIV and among men who have sex with men, there is great concern that this drug is fueling the HIV epidemic. Equally worrisome are the effects that crystal methamphetamine use can have on the prognosis and overall health of HIV-infected patients. This article reports the results of a pilot study that is part of a larger project exploring the correlates of antiretroviral therapy drug resistance.