Considering that current trends in sexual behavior and alcohol use among adolescents pose a significant public health risk, more research is needed in this area. Using a cross-sectional design, this study examined sex and alcohol behaviors among middle school and high school students in southeastern North Carolina. The findings suggested that there were strong associations between overall drinking patterns and sexual behaviors. Further analyses examined the effect of several demographic and behavioral factors on sexual experience and condom use for both middle and high school students. Alcohol, race, and age were significant determinants of sexual experience for all students while gender was significant for middle school students. None of the measured factors, including AIDS education, significantly increased condom use among sexually active students. The results suggested that sexuality and alcohol education methods and content should be reevaluated and should begin in or before middle school. (Contains 2 tables.)