Substance use and STI acquisition: Secondary analysis from the AWARE study

•We studied relationships between drug use and prevalent and incident sexually transmitted infections (STIs).•Substance use was related to STI rates and varied by gender and partner gender.•Participation in substance use treatment was associated with increased STI rates.•Focused interventions may be useful in STD clinics to reduce drug-related morbidity.•Gender-specific sexual health interventions may be useful in substance use treatment.