Aim:To describe the reported sexual behaviors of opioid-dependent young adults in a Cairo psychiatric hospital, Egypt, and examine the association between drug consumption, sexual behaviors, and family attitudes.Method:A total of 48 patients with opioid dependency according to DSM-IV-TR were recruited from inpatient psychiatric attendees at a psychiatric hospital, Cairo, Egypt. A face-to-face semistructured interview was conducted to obtain information on detailed clinical history, mental status, drug use history, psycho-sexual history, and family attitudes from patients.Results:The most frequent age group at the time of presentation of the sample was 15 to 25 years (47.9 %). The mean age of start of drug abuse was 15.8 years (SD=2.6; 11 to 25 y). The entire group was dependent on opioid and 46 (95.5%) were dependent on cannabis at the same time, and 19 (39.6%) were dependent on alcohol. The main opioids abused by the entire group were heroin (8, 16.7%), tramadol (synthetic opioid) (37, 77.1%), and codeine (cough syrup) (14, 29.2%). High rates of risky sexual behaviors were observed, particularly in tramadol users. They reported high rates of sexual activity over the previous 3 months, commercial sex work, large number of casual sex partners, and lifetime hepatitis C.Conclusion:These findings point to a clear need for interventions aimed at decreasing risky sexual behaviors among individuals with opioid dependency. Check Ovid for access View on Journal Site Related Topics Hepatitis Related Articles Executive Function, Impulsivity, and Risky Behaviors in Young Adults Neuropsychology 2019; 33(2): 212–221. Factors Associated With Risky Sexual Behaviors in Older Adults Journal of the Association of Nurses in AIDS Care 2012; 23(6): 487–499. Fracking and risky behaviors: Evidence from Pennsylvania☆ Economics & Human Biology 2018; 31(): 69–82. Interventions for Alcohol-Related Risky Sexual Behaviors Among College Students: A Systematic Review Psychology of Addictive Behaviors 2017; 31(8): 944–950. Factor associated with risky sexual behaviors among the French general population Journal of Public Health 2017; 39(3): 523–529.