Purpose: This study examined activity, daily living, health, support, and outlook in HIV+ drug users. Methods: Using the physician-administered Spitzer Index, the study assessed 75 HIV-1 seropositive men (n = 51) and women (n = 24) enrolled in the Miami HIV-1 Infected Drug Abusers Study (MIDAS). Results: Total composite scores were significantly lower in the HIV-1 infected women than the men (p = .03). Significant gender differences were observed in activity assessment, independent of disease status, with women six times as likely to have lower activity scores (p = .0038). Most women (45%) in this category were homeless or marginally housed, compared to II percent of the men. Additionally, women with low activity scores had less social support than women with high activity scares. Cocaine use was significantly related to reports of normal activity, and varied across genders; more men used cocaine than women (p = .03). Conylared to non-AIDS participants, AIDS patients were more likely to have lower scores in health (p = .009) and poorer outlook (p = .03). Implications: These findings reveal specific deficits in areas of psychosocial capacity particularly in HIV-1 infected women who abuse drugs, that may need to be strengthened in order to enhance function and adherence to treatment, as well as well-being.