This study sought to examine the determinants of sexual behaviours among adolescents living with HIV and AIDS. HIV status disclosure and felt stigma which were the determinants studied that relate to living with HIV and AIDS were found to have a close association with engagement in types of sexual behaviours among adolescents. In conclusions, this study shows that while adolescents aspire to leave relatively normal sexual lives by engaging in various types of sexual behaviours, fear to disclose HIV status to partners influence how they conducted sexual lives. One of the key finding that some adolescents engaged in unprotected sex while their preference of sex partner were those who were HIV negative, they were not willing to disclose their HIV status to them. This risk transmission of HIV to partners, acquiring other sexually transmitted infections by the HIV living adolescents, re-infection with other strains of HIV as well as having unplanned pregnancy. The key recommendation generated from this study is the need to re-examine the existing HIV primary prevention interventions that inform behaviours change communication in HIV programming with a view to addressing sexuality issues of adolescents living with HIV and AIDS.