ABSTRACTThe social, economic, and environmental determinants of health include employment, housing, and education; exposure to environmental factors like lead or access to healthy food; and poverty, racism and oppression. Many of these conditions can lead to Adverse Childhood Experiences that may put children and youth at risk for abuse or maltreatment leading to involvement in the child welfare or juvenile justice systems. All young people experience important developmental milestones on their path to becoming healthy adults, and while this time of change is full of promise, it can be a time of increased vulnerability or risk. For system-involved youth, navigating this time of change can be fraught with even more challenges or barriers. Without strong family and social networks, they may face increased risk of engaging in high-risk behaviors—such as unprotected sex and sex with multiple partners—as well as unintended pregnancy, HIV, and other sexually transmitted infections. Our study examined survey data to assess the overall sexual reproductive health behaviors for youth aged 14–21 in out-of-home care in an urban environment (n = 270; 60.7% male; 82% African American; 7.9% Latinx). Youth were recruited between 2012 and 2016; 76.4% of these teens had had sexual intercourse at some point in their lifetime. Of these, 86.0% were sexually active before the age of 16. Although there were numerous risk factors related to contraception and condom use as well as partner demographics, there were assets or strengths identified. A discussion of how these findings can be utilized to develop effective prevention intervention strategies is provided.