Many mental health problems among substance abusing populations are directly linked to high rates of abuse and trauma. There is increasing evidence of associations between childhood physical and sexual abuse to adult substance use and HIV-risk behavior. The relationship of abuse, mental health problems, substance abuse, and high-risk sexual behavior has rarely been studied in the female Native American population. Significant relationships were found among childhood abuse, trauma, substance abuse, and high-risk sexual behavior among urban Native women. (Contains 3 tables and 4 figures.)