Injecting drug use is a common mode of transmission among persons with HIV/AIDS. Many HIV-infected patients meet diagnostic criteria for opioid dependence, a chronic and relapsing brain disorder. Most HIV providers, however, receive little training in substance use disorders. Opioid agonist therapy (OAT) has a stabilizing effect on opioid-dependent patients and is associated with greater acceptance of antiretroviral (ARV) therapy, higher ARV adherence, and greater engagement in HIVrelated health care. Although methadone maintenance has been the OAT gold standard, methadone is available for the treatment of opioid dependence only in strictly regulated narcotic treatment programs. Buprenorphine, a partial opioid agonist approved for the office-based treatment of opioid dependence in 2002, may result in better health and substance use treatment outcomes for patients with HIV disease.