This study examined whether a culturally adapted version of a previously evaluated efficacious HIV prevention program reduced sexual risk behaviors of youth living with HIV (YLH) in Uganda. YLH, 14 to 21 years, were randomized to intervention (N = 50) or control (N = 50) conditions. Significantly more YLH in the intervention used condoms consistently and decreased their number of sexual partners in comparison to the control condition. Western interventions can be culturally adapted to retain efficacy in reducing the sexual risk behavior of YLH.