High-risk behavior in youths related to HIV transmission continues to occur despite large-scale efforts to disseminate information about safe sexual practices through education. Our study examined the relationships among knowledge, decision-making strategies, and risk assessment about HIV by youths during peer group focused discussions. Two focus groups with first-year college students were conducted, with a series of questions about risk for HIV transmission as prompts. All group interactions were recorded, transcribed and analyzed using methods of discourse analysis to characterize a detailed description of the interactions. The results indicated that youths negotiated their perspectives with the use of justification and elaboration to support alternative opinions and positions. They used concrete experiential examples to further explain and illustrate their positions, Opposing views or arguments met with requests for clarification and further negotiation. This cycle of clarification-negotiation shaped their understanding of HIV-related concepts. The use of strategies, such as justification of alternative positions and the use of examples as support for arguments to clarify and negotiate various perspectives, could be used as a tool for designing educational programs to improve understanding of health related issues, such as HIV transmission and prevention. © Springer 2006.