Men who have sex with men (MSM) account for a majority of all men currently diagnosed with AIDS. MSM is also recognized as the largest risk category of all AIDS cases. Drug use has been shown to have a synergistic effect on the prevalence of HIV in the MSM population. The study aimed to examine the association between injection drug use, non-injection drug use, and non-drug use with sexual risk behaviors for HIV in men who have sex with men. Secondary, cross-sectional data procured from the National HIV Behavioral Surveillance System for the Atlanta Metropolitan Survey Area were used for the study. The study population was 960 participants. Using binary logistic regression analyses, the drug use categories were studied for unprotected intercourse, unprotected receptive anal intercourse and HIV status. Strong associations were seen independently for unprotected intercourse, unprotected receptive anal intercourse, and HIV status with injection and non injection drug use, but the association weakened for drug use categories when controlled for other independent factors. Taking into account current findings and findings from previous research, the importance of clinical significance over statistical significance was considered. Racial disparities were evident, in that, although the Black participants showed no increased odds for sexual risk factors or drug use, it had a higher odds for being HIV positive compared to Whites. Combining Viagra/Levitra with drugs was significantly associated with unprotected intercourse (AOR=1.9), and each individual drug showed a different degree of association with Viagra/Levitra. Further research is recommended to identify sub-populations at risk and appropriately allocate resources and channel programs and interventions.