An HIV knowledge survey and qualitative interview were administered to 20 case managers in community-based programs for troubled youth to assess HIV knowledge and their perception of client HIV risk behaviors. Participants had good HIV knowledge. Case managers perceived client youth to be at high risk for HIV infection due to unsafe sexual practices, survival sex, vulnerability to victimization, and homelessness. Teenaged girls were seen as being at higher risk than teenage boys. Clients with stable placements and involved caregivers were deemed at lower risk due to increased emotional and behavioral support. Few case managers provided HIV prevention services due to strained resources, insufficient training, and difficulty talking about sexuality. Implications for prevention are discussed. (Contains 1 table.)