Little is known about how substance use patterns affect social stability among persons living with HIV/AIDS (PLWH). This manuscript examines associations, using survey data collected between 2003–2004, between substance use and social stability measures in 1,133 at-risk PLWH enrolled in 10 outreach programs across the US funded by the Health Resources and Services Administration. Substance use patterns were found to impact the social stability indicators of housing status, need for food, and income level. Effect varied by types and numbers of drugs used. These findings have important implications for policy and for planning effective program interventions for HIV-infected substance users.