Understanding the experiences of youth living with HIV (YLH) is necessary for implementing interventions that mitigate HIV transmission. We conducted a survey of sexual behaviours and sources of knowledge among 107 youths aged 16-24 attending two HIV clinics in Kigali, Rwanda. Respondents were 72% women and 28% men, with median age 18 years. Of those sexually active in the past six months, 56% reported inconsistent condom use; 53% of sexually active respondents reported having sexually transmitted infection (STI) symptoms in the past six months. The median age difference between respondent and first sex partner was nine years for women, and 0.5 years for men (P = 0.006). Women more frequently reported being forced to have sex (29% girls versus 6.5% boys, P = 0.011) and exchanging sex for money (66% girls versus. 17% boys, P = 0.033). Strengthening female YLH's financial and material resources may reduce the number of sexual partners, asymmetries within partnerships and risk of HIV transmission.