In Australia, there is a growing expectation that sexuality education should reduce the risks associated with youth sex by providing young people with information on protecting their sexual health. However, this information may be insufficient to ensure that young people make choices that support their sexual safety and autonomy. This paper considers the adverse implications of the problematisation of youth sexuality for young people's sexual health and autonomy. It draws on interview and focus group data from 117 young people to explore the varying opportunity that youth have to actively negotiate and promote safe and consensual sex. Finally, implications for sexuality education and violence prevention are briefly considered.