The use of crack cocaine and its associations with high-risk sexual behavior in view of the AIDS epidemic is reported commonly for major East and West Coast urban centers. This article describes and analyzes ethnographic data on crack use in Dayton, Ohio, a small midwestern city of less than 200,000 people. The results of 15 tape-recorded interviews are employed to sketch the basic outlines of crack use among African-Americans. A major focus is placed on analyzing the characteristics of the exchange of crack for sexual favors. High-risk behaviors for the transmission of HIV and other sexually transmitted diseases are explored.