The principal aim of this study of adolescents in Mbale District, Uganda, is to provide program-related information about their behavior, motivations, and perceptions of risk with regard to pregnancy and HIV transmission. Twelve single-sex focus-group discussions were conducted, six with young people aged 17–18 who were still attending school, and six with people of the same age who were not. The most important findings to emerge are that knowledge of safe-sex behavior and reported behavior have little in common and that the fundamental barriers to behavioral change lie within the economic and sociocultural context that molds the sexual politics of youth. Young males' lack of responsibility for the outcomes of their behavior is identified as an important barrier to improved sexual health. The imperative to explore ways by which young women might achieve status and identity and acquire material resources by means not related to their sexuality is highlighted.