Abstract: This dissertation explores whether family relationship factors are associated with HIV/AIDS risk reduction service utilization among women injection drug users (IDUs). Women IDUs are at high risk of HIV and often in high need of HIV risk reduction services. Prior research demonstrates that women's family relationships are associated with their substance abuse and HIV risky behaviors. Less is known about the relationship between family factors and health services use. Based on the theoretical frameworks developed by Aday & Andersen (1974) and Amara (1995) this dissertation uses quantitative and qualitative methods to explore the association between women IDU's family relationships, with both spouses/sex partners and minor children, and their use of HIV/AIDS risk reduction health services. First, data from a sample of 198 injection drug-using (IDU) women were analyzed using logistic regression techniques. Controlling for key predisposing, enabling, and need factors significant at the bivariate level (age, race/ethnicity, education, homelessness, employment, income, mental health symptoms, and injection drug use), the findings indicated that: (1) living with children was significantly and positively associated with the use of drug treatment, mental health treatment and needle exchange programs (NEPs); (2) living with a partner or spouse was positively and significantly associated with use of (NEP) services and; (3) African American women were less likely to use drug and mental health treatment, psychiatric medications, and NEPs than their white counterparts. Living with children was also significantly associated with overall higher scores on the Magnitude of Health Services Index (MHSI), an exploratory measure specifically developed for this dissertation. Qualitative analysis of interviews conducted with a sub-group of 14 women IDUs selected from the larger sample suggested three different themes. First, women's health services use seemed influenced by trauma legacies that began in childhood and continued into adulthood. Second, the women described role conflicts as they struggled with their motherhood performance while addicted to drugs. Finally, the theme of mandated to treatment revealed how mothers' relationships with their children facilitated treatment. An implication of this study is that family relationships are essential elements in women IDU's use of HIV/AIDS risk reduction services and need to be essential components in future research, policy, and practice HIV prevention efforts for women.