This study describes the prevalence of risky sexual activities among Bolivian adolescents within the context of other behavioral factors that contribute to compromised health outcomes, unintended pregnancies, and sexually transmitted infections including HIV/AIDS. Data was collected from 576 adolescents, 13-18 years of age, from six schools in La Paz, Bolivia, using the Youth Risk Behavior Surveillance Survey. Findings indicate that males were more likely than females to report having ever engaged in sex, initiated sexual activity at age 14 or younger, and had two or more sexual partners within the three months prior to the survey. For both sexes, those who initiated sexual activity at an early age were more likely to engage in a variety of risk behaviors, with alcohol as the most significant risk factor. The likelihood of engaging in sexual activity is associated with age, low academic performance, substance abuse, violence, depression, and suicidal tendencies. The more frequent the occurrence of these risk factors, the higher the chances of engaging in sexual activity. Future research should examine efforts to simultaneously reduce multiple risk factors and to determine how adolescents' views on reproductive issues influence sexual initiation and patterns of sexual behavior over time. (Contains 3 tables and 1 figure.)