This research evaluated risk behaviors in HIV-positive adolescents (N = 153) receiving routine HIV medical care from their providers at a large medical center in Bucharest, Romania. Although the participants were of an appropriate age (M = 15.94 years) to have acquired HIV as one of the large numbers of pediatric AIDS cases during Ceauşescu's Communist regime, many (20%) reported acquiring HIV sexually, relatively recently. The sample as a whole exhibited significant deficits in HIV knowledge, attitude, subjective norm, perceived control, and intention; significant risk behavior also appeared in terms of reports of unprotected intercourse with both HIV-positive and -negative partners. These results imply a change in the epidemiological model for HIV transmission in Romania, with increased sexual transmission of HIV. Discussion centers on interpretations of these patterns and drawing implications for HIV risk reduction for young people in Romania.