Based on ethnographic research carried out in shantytowns in the Metropolitan Area of Buenos Aires, this article examines changes taking place in the process of the formation of heterosexual couples, the development of practices locally conceived of as “care,” and their relationship to drug consumption and the survival of drug users. It shows how this trend in the formation of heterosexual couples entails a compromise among multiple social processes (territorial isolation, health vulnerability, and the incarceration and death of young people). The analysis demonstrates, through the lens of the privatization of care, the consequences of these processes for these couples. It also shows how such processes reinforce patriarchal gender stereotypes. [Argentina, gender, health, social anthropology, urban]