This study provides insight into some sociostructural factors that may impact the experiences of HBCU students and influence their HIV/AIDS-related perceptions or use of prevention strategies on campuses. To the authors' knowledge, this is the first study that addresses the potential influence of campus-related structural risks on the HIV prevention strategies and perceptions of HBCU students. Based on these findings, HBCUs should consider additional exploration of student, as well as administrator, perspectives that can lead toward the development and implementation of a campus-specific sexual health and HIV prevention curriculum for the benefit of students, administration, and staff members. Further examination of HBCU institutional infrastructure with the goal of increasing students' comfort level regarding condom acquisition and HIV testing is also critically necessary to enhance campus HIV awareness and prevention efforts. The positive aspects of paternalism that remain present on many HBCU campuses today should be explored as a foundation on which to build culturally relevant programs that can positively influence students' sexual health decision making. (Contains 2 tables.)