This study focuses on a sample of men who have sex with men (MSM) living with HIV/AIDS in a south Florida community. The study uses a mixed-method, quantitative, and qualitative research design. The purpose of the study was to identify individual and service system characteristics that impact access, retention, and adherence to an HIV/AIDS medical treatment regimen. The study identified many men who were not likely to seek treatment after their initial HIV/AIDS diagnosis. Compared with the general population living with HIV/AIDS in the same south Florida community many of these men were less likely to maintain a regimen of medical care for their HIV/AIDS. The study indicated that the following issues affected medical treatment and treatment adherence: treatment readiness, presence of support networks, availability of "MSM-friendly" health providers, and the cultural competency of substance abuse providers.