Little is known about the use of preventive health services by HIV-seronegative IDUs. This study examines screening and preventive health services use by two populations of HIV-seronegative IDUs recruited from a needle exchange program and methadone program. We found high rates of HIV and tuberculin skin testing in the past year as well as tetanus vaccination among both groups of IDUs. Hepatitis B and C testing was significantly higher in the methadone group than the needle exchange group. Syphilis testing and pneumovax administration was disappointingly low in both groups. Given the burden of disease among IDUs, our findings suggest the need for a distinct set of testing and vaccination guidelines for the HIV-seronegative IDU population.