Sexual violence prevention programs are important for addressing sexual violence and are often implemented in local community and university settings. However, program implementer perspectives are often missing from academic research literature, limiting access to practical knowledge that can provide insights to improving programs and prevention. This study illustrates the landscape of sexual violence primary prevention work in a Midwestern metropolitan area. Seven interviews with community and university implementers took place in 2020, providing information about local prevention programs and expert insights to community prevention culture. Geographic data about implementation locations was also collected to visually assess coverage of preventive services and confirm that the major sub-areas of the metropolitan area were represented by this research. Interviews provided descriptions of local programs implemented with adolescents and young adults which usually took place in school or university settings and focused on healthy relationships. Capacity was most often cited as a challenge faced internally, whereas broader outer contexts may inhibit or support prevention externally. Findings capture the perspectives of sexual violence prevention program implementers, including discussion of tensions related to adaptation versus fidelity and how implementation contexts specific to this programming may influence implementation.