The emergence of AIDS has triggered significant change in drug user treatment practices. The vast majority of programs are involved in some aspects of AIDS prevention counseling, large numbers encourage HIV testing, and an increasing number of programs offer on-site testing. Resources available to drug user treatment for AIDS prevention will likely depend on the perceived threat of AIDS to the larger community, and the public's belief in the capacity of treatment programs to reduce that threat. Programs will likely face often contradictory demands regarding service delivery. They may be asked to increase client flow while also retaining clients more effectively, providing aftercare, and working with the client's sexual partner(s). It will be the role of program administrators to provide for staff recruitment, retention, and support in an increasingly difficult environment. Alternative treatment settings will need to be explored for those intravenous drug users who cannot or will not enter existing treatment programs.