Young people living with HIV are challenged when it comes to exploring their sexuality. Their sex education is hampered by the fact that their preferences and attitudes towards sexual behaviour are little known about. In this study from the Netherlands, Q-methodology was used to identify sizeable and meaningful sub-groups sharing common attitudes and viewpoints. Thirty of 48 eligible HIV-positive young people aged 12-21 years treated in one of the four Dutch HIV centres rank-ordered 45 statements on the topic. Thereafter, they explained their ranking. By-person factor analysis identified five distinct sexual behaviour profiles (SBPs): (a) safer sex & disclosure to steady partner; (b) motivated by faith and culture; (c) disclosure to good friends, values peer support; (d) conscientious, worries about disclosure and future; (e) self-confident, faith and family are important. Profiles differ in terms of the roles of culture and religion, the influence of family and friends, personal views about disclosure of HIV status, knowing the transmission mode, and viral load. Study results indicate that different approaches to sexual health education are required based on these different orientations. Q-sorts and SBPs may be helpful in discussing sexual behaviour with HIV-positive young people and in developing tailored strategies to meet their interests and needs.