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Gang violence, substance abuse and AIDS have been descr1bed as parallel epidemics in the U.S inner city. This paper draws upon findings from a set of ethnographic and survey research projects in the Puerto Rican community of Hartford ,CT to develop a conceptualization of the close Interconnections between these three health and social problems. Rather than separate conditions. Substance abuse, violence, and AIDS, referred to here as SAVA to stress the relationships among these three phenomena are best thought of forming a single syndetic (a closely interrelated complex of health and social crises) that continues to take a significant toll on the lives and well-being of the urban poor.